Colonic-type adenocarcinoma (somatic-type malignancy) arising in a mediastinal mature cystic teratoma: A case report of a rare entity

Khurana, Anuj; Mehta, Anurag; Kamboj, Meenakshi

doi:10.4103/0377-4929.77405

Cited by 11 publications

(9 citation statements)

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“…Patients with teratoma with SMT have a varying prognosis. Patients able to undergo complete resection of the malignant component were reported to have had an excellent outcome [27], whereas a median OS of only 9 months was reported for those with metastatic disease [28]. In our cohort, the median OS was only 6 months.…”

Section: Discussionmentioning

confidence: 65%

Clinical Characteristics and Treatment Outcomes of Patients with Primary Mediastinal Germ Cell Tumors: 10-Years' Experience at a Single Institution with a Bleomycin-Containing Regimen

et al. 2016

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Background: Cisplatin-based chemotherapy followed by surgical resection of the residual tumor remains the standard of care for patients with mediastinal germ cell tumors (MGCTs). To prevent pulmonary complications, a non-bleomycin-containing regimen is generally preferred. This study aims to review the clinical characteristics and outcomes of these patients. Methods: A retrospective chart review was undertaken in patients treated for MGCTs between 2003 and 2013. Results: A total of 40 patients were enrolled; 7 patients were diagnosed with seminoma, while 33 patients had non-seminoma. 92% of patients received chemotherapy as a first treatment modality: 87% bleomycin, etoposide and cisplatin; 13% etoposide and cisplatin, with an objective response rate of 61.3%. Among these, 44% achieved a complete serological response. 17 patients underwent surgical resection of the residual tumor. No patient suffered from pulmonary complications after surgery. The 5-year overall survival (OS) was 71.4 and 27.3% in seminoma and non-seminoma patients, respectively (p = 0.051). For those who received chemotherapy followed by surgical resection with no viable tumor or only mature teratoma detected, the 5-year OS was 72.7% compared with 20.7% in patients not treated with surgery (p = 0.02). Conclusion: Our study confirmed the importance of a multimodality approach with primary chemotherapy followed by surgical resection of the residual tumor. A bleomycin-containing regimen can be safely used in this setting.

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Section: Discussionmentioning

confidence: 65%

Clinical Characteristics and Treatment Outcomes of Patients with Primary Mediastinal Germ Cell Tumors: 10-Years' Experience at a Single Institution with a Bleomycin-Containing Regimen

et al. 2016

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“…Complete surgical resection plays an essential role in therapy when the tumor is limited to a single site [11]. There is no response to chemotherapy used for treatment of germ cell tumors; however, adapted chemotherapy based on histology (such as 5-fluorouracil-based regimens for adenocarcinoma transformation) has recently been advocated, and it may help improve patient outcomes [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…A diagnosis of teratoma with somatic-type malignancy, especially in the mediastinum, confers a poor prognosis, with a high frequency of metastasis and recurrence [1,2,11]. It is important to identify the malignant component within these neoplasms, because they can infiltrate adjacent organs or even metastasize, thereby increasing the disease [1,2].…”

Section: Discussionmentioning

confidence: 99%

Mediastinal Teratoma with Coexisting Adenocarcinoma and Carcinoid Tumor (Somatic-Type Malignancy): A Case Report with a Review of the Literature

et al. 2015

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Germ cell tumors constitute 10% to 15% of anterior mediastinal neoplasms. Of these, mature teratoma is the most common. Somatic malignant transformation in mature teratoma is a very rare phenomenon. In the anterior mediastinum, few cases of malignant transformation in the form of carcinoma, sarcoma, or neuroendocrine tumors have been described. We present the case of a mature mediastinal teratoma in a 24-year-old female, diagnosed on computed tomography, where both carcinoid tumor and adenocarcinoma were seen. To the best of our knowledge, this is the first report of such a case. Malignant transformation in a mature teratoma confers a significantly worse prognosis and is difficult to diagnose only on clinical and radiological evaluation. As these lesions are so rare, the treatment options for these lesions are also not clearly defined. Extensive sampling and careful microscopic examination are needed when teratomas are submitted for pathological evaluation.

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“…No standard adjuvant therapy is recommended since TMT is considered resistant to chemotherapy and radiotherapy [3]. The prognosis of mediastinal GCTs with TMT is extremely poor, especially when metastasis occurs, with a median survival of approximately 9 months [7]. In that advanced setting, adapted chemotherapy based on transformed histology has recently been advocated, which may help improve patients' outcome [5].…”

Section: Disscusionmentioning

confidence: 99%

“…To date, four cases of colonic-type adenocarcinoma arising in a teratoma have been reported [4, 7–9]. Two were primary retroperitoneal teratoma while the other two were mediastinal teratoma, all with prominent adenocarcinomatous transformation.…”

Section: Disscusionmentioning

confidence: 99%

Superior mediastinal mature cystic teratoma with gastrointestinal adenocarcinoma transformation: Report of a case

Chen

et al. 2016

Oncotarget

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Presented herein is a case of mediastinal mature teratoma with adenocarcinomatous transformation predominantly composed of mucinous adenocarcinoma in a 25-year-old man. Disease progressed despite application of surgical removal, adjuvant radio- and chemotherapy. Further immunohistochemical stains indicated a gastrointestinal origin of the tumor. Consequently chemotherapy according to the FOLFIRI regimen was applied that resulted in good response. To our knowledge, this is the first report of a clinical remission from chemotherapy with the FOLFIRI regimen after comprehensive initial treatment with surgery, radio- and chemotherapy for a patient with teratoma with malignant transformation, highlighting the importance of choosing an appropriate chemotherapy regimen.

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Colonic-type adenocarcinoma (somatic-type malignancy) arising in a mediastinal mature cystic teratoma: A case report of a rare entity

Cited by 11 publications

References 0 publications

Clinical Characteristics and Treatment Outcomes of Patients with Primary Mediastinal Germ Cell Tumors: 10-Years' Experience at a Single Institution with a Bleomycin-Containing Regimen

Clinical Characteristics and Treatment Outcomes of Patients with Primary Mediastinal Germ Cell Tumors: 10-Years' Experience at a Single Institution with a Bleomycin-Containing Regimen

Mediastinal Teratoma with Coexisting Adenocarcinoma and Carcinoid Tumor (Somatic-Type Malignancy): A Case Report with a Review of the Literature

Superior mediastinal mature cystic teratoma with gastrointestinal adenocarcinoma transformation: Report of a case

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