Mediastinal germ cell tumor with associated myeloid sarcoma: An exceptional co-occurrence
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The association of mediastinal germ cell tumor (GCT) and hematological malignancy is a well-documented but extremely rare phenomenon. This syndrome is characterized by the occurrence of nonseminomatous mediastinal germ cell tumor and an associated hematological neoplasm that usually involve the megakaryocytic lineage. The hematopoietic malignancies can involve the mediastinum or present as infiltration of bone marrow or lymphoid organs. In majority of cases, the hematological malignancy was detected in the bone marrow simultaneously or within 6 months after the detection of mediastinal germ cell tumor. There are very few limited case reports on the presence of hematopoietic or leukemic cells within the germ cell tumor itself and mass formation due to myeloid sarcoma is exceptionally rare. Herein we report the case of a 36-year-old male patient with a large mediastinal mass, excision biopsy of which showed areas of yolk sac tumor, immature teratoma and a separate round cell component. On immunohistochemical examination, the round cell component showed positivity for CD45 (dim), CD43, MPO, CD11c, and CD68 and were negative for CD117, CD20, CD5, CD34, Tdt, CD30, CD123, and CD61. A diagnosis of mediastinal germ cell tumor with yolk sac tumor and immature teratoma components and associated myeloid sarcoma was given. Peripheral smear and bone marrow examination showed no evidence of leukemic involvement.
KeywordsMediastinal germ cell tumor Myeloid sarcoma Yolk sac tumor
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Conflict of interest
The authors declare that they have no conflict of interest.
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