Cargando…
Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report
RATIONALE: Mediastinal non-seminomatous germ cell tumors (MNSGCTs) are rare malignancies. Chemotherapy followed by surgical resection has been regarded as the standard management, but treatment options for chemotherapy-refractory patients or those with unresectable tumors are limited, resulting in a...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556032/ https://www.ncbi.nlm.nih.gov/pubmed/34713845 http://dx.doi.org/10.1097/MD.0000000000027617 |
_version_ | 1784592098883796992 |
---|---|
author | Ren, Congcong Zhao, Jing Kang, Lin Di, Yan Qiu, Gang Wang, Qingxue |
author_facet | Ren, Congcong Zhao, Jing Kang, Lin Di, Yan Qiu, Gang Wang, Qingxue |
author_sort | Ren, Congcong |
collection | PubMed |
description | RATIONALE: Mediastinal non-seminomatous germ cell tumors (MNSGCTs) are rare malignancies. Chemotherapy followed by surgical resection has been regarded as the standard management, but treatment options for chemotherapy-refractory patients or those with unresectable tumors are limited, resulting in a very poor prognosis. PATIENT CONCERNS: An 18-year-old female presented with symptoms of cough, chest tightness, and shortness of breath for 2 months, and the symptoms gradually worsened. DIAGNOSIS: Computed tomography (CT) revealed a large mediastinal mass invading the pericardium and great blood vessels. Serum human chorionic gonadotropin (HCG) and α-fetoprotein (AFP) levels were normal. Histopathological examination of biopsy specimens revealed mixed MNSGCT with embryonal carcinoma and immature teratoma components. INTERVENTIONS: The patient achieved complete remission (CR) and long-term survival after multimodal therapy comprising chemotherapy, positron emission tomography/CT (PET/CT)-guided volumetric-modulated arc therapy (VMAT), and anti-angiogenic targeted therapy. OUTCOMES: The patient was followed up for more than 4 years without recurrence, metastasis, or treatment-related adverse effects. LESSONS: The case presented here highlights the importance of multidisciplinary diagnosis and treatment, providing evidence that radiotherapy and anti-angiogenic therapy may play an important role in unresectable or residual tumors after failure of conventional treatments of MNSGCT. Percutaneous biopsy is necessary for diagnosis if the tumor is unresectable, and serum AFP and HCG levels are normal. Additionally, PET/CT is an effective method for evaluation of efficacy and radiotherapy guidance for patients with MNSGCTs. |
format | Online Article Text |
id | pubmed-8556032 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-85560322021-11-01 Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report Ren, Congcong Zhao, Jing Kang, Lin Di, Yan Qiu, Gang Wang, Qingxue Medicine (Baltimore) 5700 RATIONALE: Mediastinal non-seminomatous germ cell tumors (MNSGCTs) are rare malignancies. Chemotherapy followed by surgical resection has been regarded as the standard management, but treatment options for chemotherapy-refractory patients or those with unresectable tumors are limited, resulting in a very poor prognosis. PATIENT CONCERNS: An 18-year-old female presented with symptoms of cough, chest tightness, and shortness of breath for 2 months, and the symptoms gradually worsened. DIAGNOSIS: Computed tomography (CT) revealed a large mediastinal mass invading the pericardium and great blood vessels. Serum human chorionic gonadotropin (HCG) and α-fetoprotein (AFP) levels were normal. Histopathological examination of biopsy specimens revealed mixed MNSGCT with embryonal carcinoma and immature teratoma components. INTERVENTIONS: The patient achieved complete remission (CR) and long-term survival after multimodal therapy comprising chemotherapy, positron emission tomography/CT (PET/CT)-guided volumetric-modulated arc therapy (VMAT), and anti-angiogenic targeted therapy. OUTCOMES: The patient was followed up for more than 4 years without recurrence, metastasis, or treatment-related adverse effects. LESSONS: The case presented here highlights the importance of multidisciplinary diagnosis and treatment, providing evidence that radiotherapy and anti-angiogenic therapy may play an important role in unresectable or residual tumors after failure of conventional treatments of MNSGCT. Percutaneous biopsy is necessary for diagnosis if the tumor is unresectable, and serum AFP and HCG levels are normal. Additionally, PET/CT is an effective method for evaluation of efficacy and radiotherapy guidance for patients with MNSGCTs. Lippincott Williams & Wilkins 2021-10-29 /pmc/articles/PMC8556032/ /pubmed/34713845 http://dx.doi.org/10.1097/MD.0000000000027617 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 5700 Ren, Congcong Zhao, Jing Kang, Lin Di, Yan Qiu, Gang Wang, Qingxue Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report |
title | Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report |
title_full | Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report |
title_fullStr | Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report |
title_full_unstemmed | Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report |
title_short | Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: A case report |
title_sort | successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor: a case report |
topic | 5700 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556032/ https://www.ncbi.nlm.nih.gov/pubmed/34713845 http://dx.doi.org/10.1097/MD.0000000000027617 |
work_keys_str_mv | AT rencongcong successfultreatmentofradiotherapyandapatinibinpatientwithmediastinalmixednonseminomatousgermcelltumoracasereport AT zhaojing successfultreatmentofradiotherapyandapatinibinpatientwithmediastinalmixednonseminomatousgermcelltumoracasereport AT kanglin successfultreatmentofradiotherapyandapatinibinpatientwithmediastinalmixednonseminomatousgermcelltumoracasereport AT diyan successfultreatmentofradiotherapyandapatinibinpatientwithmediastinalmixednonseminomatousgermcelltumoracasereport AT qiugang successfultreatmentofradiotherapyandapatinibinpatientwithmediastinalmixednonseminomatousgermcelltumoracasereport AT wangqingxue successfultreatmentofradiotherapyandapatinibinpatientwithmediastinalmixednonseminomatousgermcelltumoracasereport |