Yolk sac primary tumor of mediastino: a rare case in a young adult

Silva, Lorena Luryann Cartaxo da; Vergílio, Fernanda Sasaki; Yamaguti, Diva Carvalho Collarile; Cruz, Isabela Azevedo Nicodemos da; Queen, Joana Angrisani Granato

doi:10.1590/s1679-45082017rc4008

Cited by 9 publications

(11 citation statements)

References 9 publications

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“…Meanwhile, the VIP regimen, as another alternative of chemotherapy, was reported to have the similar efficacy to BEP, and it is more suitable for patients who are awaiting surgery because of the lower pulmonary toxicity. However, similar to the case in our report, some studies have showed that BEP and VIP have no significant effect on tumor size 6,15,19,20 . To date, opinions on the necessity of chemotherapy and the selection of chemotherapy scheme, still remains controversial.…”

Section: Discussionsupporting

confidence: 84%

“…In PubMed, the English case reports and case series of PMYST during the past decade were searched. The following key words were used for the database search: “yolk sac tumor,” “mediastinum,” “mediastinal.” A total of 73 articles were retrieved, in which 22 articles on the therapy and prognosis of PMYST were extracted, including 16 case reports and 6 case series, involving 52 patients in total 5–26 . Out of all the patients, only six female cases were reported.…”

Section: Literature Reviewmentioning

confidence: 99%

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Primary mediastinal yolk sac tumor: A case report and literature review

Zhang

2023

Clinical Case Reports

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Key Clinical MessageThere are limited published cases of primary mediastinal yolk sac tumor (PMYST), with no consensus on the best treatment alternative. By far, the surgery oriented comprehensive therapies are the main treatment methods. The surgical strategy should be individualized and aimed at radical resection, considering all the possibilities, including the use of cardiopulmonary bypass and prosthetic materials.AbstractA 15‐year‐old boy was diagnosed as PMYST. The tumor, with a size about 13 × 12 × 8 cm, was located in the right upper mediastinum, closely adhering to ascending aorta, superior vena cava, right atrium, and the right hilum. After 6 cycles chemotherapy of bleomycin, etoposide, and cisplatin (BEP), no significant change was found in the size of tumor. Subsequently, an extended tumor excision including partial resection of the right lung, the pericardium, the diaphragm and the right phrenic nerve, was performed successfully with cardiopulmonary bypass on standby. During 6 months of follow‐up, there was no tumor recurrence. Meanwhile, in PubMed, we searched the English case reports and case series of PMYST during the past decade. A total of 73 articles were retrieved, in which 22 articles on the therapy and prognosis of PMYST were extracted and reviewed, included 16 case reports and 6 case series with a total of 52 patients. Due to the rarity of PMYST, it is difficult to provide a specific treatment regimen. The surgery‐oriented comprehensive therapies are still the main treatment methods. The surgical strategy should be individualized and aim at radical resection, considering all the possibilities, including the use of cardiopulmonary bypass and prosthetic materials.

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Section: Discussionsupporting

confidence: 84%

Section: Literature Reviewmentioning

confidence: 99%

Primary mediastinal yolk sac tumor: A case report and literature review

Zhang

2023

Clinical Case Reports

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“…They often occur in the middle axis of the body, such as the brain, mediastinum, and retroperitoneum. 1 Mediastinal YSTs are more popular in infancy and post-puberty. 2…”

Section: Introductionmentioning

confidence: 99%

Dramatic response to local radiotherapy in a refractory metastatic mediastinal yolk sac tumor patient harboring a germline BRCA2 frameshift mutation: a case report

Cheng

et al. 2022

Cancer Biology & Therapy

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Mediastinal yolk sac tumors (YSTs) are highly aggressive germ cell tumors with an extremely poor prognosis. Radiotherapy plays an important role in the treatment of mediastinal YSTs. To maximize benefit from radiotherapy in patients with mediastinal YSTs, exploring functionally relevant biomarkers is essential. Previous studies have demonstrated that mutations in DNA-damage repair (DDR) genes, including BRCA1/2 , potentially enhance sensitivity to radiotherapy in solid tumors. However, DDR-gene mutations, as possible predictive biomarkers for radiotherapy in primary mediastinal YSTs, have not yet been reported. Herein, we report a 29-year-old male patient with a refractory metastatic primary YST involving a germline frameshift mutation in the BRCA2 gene (NM_000059.3: exon11: c.4563_4564delAT: L1522fs). During treatment alternation, the patient was found to respond poorly to chemotherapy with or without an immune checkpoint inhibitor but well to radiotherapy. Finally, the patient achieved approximately 17 months of overall survival. To the best of our knowledge, this case report is the first to describe a remarkable response to local radiotherapy in a patient with a refractory metastatic mediastinal YST involving a DDR-gene mutation (germline BRCA2 frameshift variation). This case report provides insightful clues for precision radiotherapy in clinical practice.

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“…Patients often present with advanced, bulky tumors that are unresectable. A comprehensive treatment with initial chemotherapy followed by surgical removal of all residual tumors is recommended 3–6 …”

Section: Introductionmentioning

confidence: 99%

“…A comprehensive treatment with initial chemotherapy followed by surgical removal of all residual tumors is recommended. [3][4][5][6]…”

Section: Introductionmentioning

confidence: 99%

Multimodal imaging changed clinical decision‐making: A rare mediastinal yolk sac tumor infiltrating the heart and follow‐up

Yang

Liu

2021

Echocardiography

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Background: Primary yolk sac tumor of the mediastinum is an extremely rare and highly malignant neoplasm, affecting mainly young men. Method and result:This case report describes a 60-year-old man with a mediastinal yolk sac tumor and infiltrating the heart. A large mobile mass was found in the right atrium by transthoracic echocardiography, and myxoma was suspected. However, contrast-enhanced ultrasonography imaging revealed a remarkable enhancement in the mass. Highly metabolized mass was not only found in the right atrium, also in superior vena cava and right superior mediastinum by whole-body positron emission tomography-computed tomography. Supraclavicular lymph node biopsy confirmed the tumor as a primary mediastinum yolk sac. The tumor started to shrink during chemotherapy and AFP levels decreased. This patient significantly benefited from the chemotherapy. Conclusion:Multimodal imaging plays a vital role in the diagnostic workup and management for cardiac mass.

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Yolk sac primary tumor of mediastino: a rare case in a young adult

Cited by 9 publications

References 9 publications

Primary mediastinal yolk sac tumor: A case report and literature review

Primary mediastinal yolk sac tumor: A case report and literature review

Dramatic response to local radiotherapy in a refractory metastatic mediastinal yolk sac tumor patient harboring a germline BRCA2 frameshift mutation: a case report

Multimodal imaging changed clinical decision‐making: A rare mediastinal yolk sac tumor infiltrating the heart and follow‐up

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