Mediastinal germ cell tumor presenting with bone marrow metastases: An unusual pattern of relapse demonstrated with 18F-FDG PET–CT

Sharma, Pramod Kumar; Sachar, Sudhir; Dhull, Varun Singh; Jain, T.K.; Bal, Chandrasekhar; Kumar, Rakesh

doi:10.1016/j.remn.2013.07.004

Cited by 1 publication

(6 citation statements)

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“…Radiographic examination, including PET‐CT, did not indicate GCT metastases to the bone marrow. A previous report on bone marrow metastases in a mediastinal ExGCT patient suggested that PET‐CT was useful for the detection of bone marrow metastases in GCT patients 3 . However, PET‐CT was not recommended as a follow‐up examination for non‐seminomatous GCT due to its low sensitivity 14,15 and PET‐CT was not useful in our case.…”

Section: Discussionmentioning

confidence: 70%

“… 8 Metastases of GCTs to the bone marrow are extremely rare, and all previously reported cases involve metastases to the bone marrow in patients with mediastinal GCT. 2 , 3 To the best of our knowledge, this is the first case of bone marrow metastasis in a patient with TGCT presenting with pancytopenia.…”

Section: Discussionmentioning

confidence: 78%

“…Unlike usual bone metastasis, bone marrow metastasis shows diffuse infiltrate growth in the bone marrow which sometimes causes systemic hematologic disorders such as pancytopenia 8 . Metastases of GCTs to the bone marrow are extremely rare, and all previously reported cases involve metastases to the bone marrow in patients with mediastinal GCT 2,3 . To the best of our knowledge, this is the first case of bone marrow metastasis in a patient with TGCT presenting with pancytopenia.…”

Section: Discussionmentioning

confidence: 85%

“…TGCTs are the most common cancer in young adult men 1 . Although advanced TGCTs commonly metastasize to the lymph nodes, lungs, liver, and brain, metastases to the bone marrow in TGCT patients are rare 2,3 . Standard treatment for advanced TGCT is cisplatin‐based chemotherapy followed by the resection of residual tumor after normalization of serum tumor markers such as AFP and hCG.…”

Section: Introductionmentioning

confidence: 99%

“… 1 Although advanced TGCTs commonly metastasize to the lymph nodes, lungs, liver, and brain, metastases to the bone marrow in TGCT patients are rare. 2 , 3 Standard treatment for advanced TGCT is cisplatin‐based chemotherapy followed by the resection of residual tumor after normalization of serum tumor markers such as AFP and hCG. Although 80% of patients with advanced TGCT are successfully cured, 20% become refractory to standard therapy, resulting in elevated serum tumor marker.…”

Section: Introductionmentioning

confidence: 99%

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Bone marrow metastasis in a patient with non‐seminomatous testicular germ cell tumor

et al. 2022

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Introduction Metastasis to the bone marrow is rare in testicular germ cell tumor patients. We report a case of a patient with a non‐seminomatous testicular germ cell tumor who presented with bone marrow metastases after intensive chemotherapy. Case presentation A 36‐year‐old man was admitted to the hospital with pancytopenia. Previously, he had received intensive care for an advanced left testicular germ cell tumor. Although multidisciplinary treatments including several regimens of salvage chemotherapy, desperation retroperitoneal lymph node dissection, and focal radiotherapy were performed, the serum tumor marker alfa‐fetoprotein was not normalized and there were no findings of relapse by several imaging modalities. Bone marrow aspirate, conducted to diagnose a cause of pancytopenia, revealed metastatic germ cell tumors in the bone marrow. Conclusion Bone marrow metastasis should be considered as a differential diagnosis in patients with germ cell tumors whose serum tumor makers are not normalized without any radiographic finding of recurrence.

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Section: Discussionmentioning

confidence: 70%