원발성 종격동 비정상피종성 생식세포종 3예

Three cases of primary mediastinal Nonseminomatous germ cell tumors

  • 이순일 (건국대학교 의과대학 내과학교실) ;
  • 용석중 (연세대학교 원주의과대학 내과학교실) ;
  • 송광선 (연세대학교 원주의과대학 내과학교실) ;
  • 신계철 (연세대학교 원주의과대학 내과학교실) ;
  • 양경무 (연세대학교 원주의과대학 병리학교실) ;
  • 조미연 (연세대학교 원주의과대학 병리학교실) ;
  • 임형래 (건국대학교 의과대학 내과학교실) ;
  • 유광하 (건국대학교 의과대학 내과학교실) ;
  • 조화상 (건국대학교 의과대학 내과학교실) ;
  • 유종길 (건국대학교 의과대학 내과학교실) ;
  • 송종오 (건국대학교 의과대학 내과학교실)
  • Lee, Soon Il (Department of Internal Medicine, Kon-Kuk University College of Medicine) ;
  • Yong, Suk Joong (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Song, Kwang Seon (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Shin, Kye Chul (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Yang, Kyung Moo (Department of Pathology, Yonsei University Wonju College of Medicine) ;
  • Cho, Mee Yon (Department of Pathology, Yonsei University Wonju College of Medicine) ;
  • Lim, Hyung Rae (Department of Internal Medicine, Kon-Kuk University College of Medicine) ;
  • Yoo, Kwang Ha (Department of Internal Medicine, Kon-Kuk University College of Medicine) ;
  • Cho, Hwa Sang (Department of Internal Medicine, Kon-Kuk University College of Medicine) ;
  • Yoo, Jong Kil (Department of Internal Medicine, Kon-Kuk University College of Medicine) ;
  • Song, Jong Oh (Department of Internal Medicine, Kon-Kuk University College of Medicine)
  • 발행 : 1996.12.30

초록

저자들은 젊은 연령의 성인 남자들에서 종격동에 발생한 원발성 종격동 비정상피종성 생식세포종 3예를 수술적 제거 및 화학요법을 통해 치료하던 중 암표식인자의 의미있는 감소와 종양 크기의 감소를 얻었으나 종양 재발에 대한 보조 화학 요법후 합병증이 발생한 경험을 하였기에 이를 보고하는 바이다.

Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recwrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.

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