Abstract
Primary malignant mediastinal seminomas (PMMS) are rare tumors accounting for 1–6% of all mediastinal tumors. PMMS mostly affect young men, arising from primordial germ cells that abnormally migrate from the ectoderm of the yolk sac to the gonadal region. They are clinically and biologically distinct from primary testicular tumors and seem to have a worse prognosis. Due to the rarity of the disease, the choice of treatment is a matter of debate. Literature data do not show any association between this kind of tumor and malignant Schwannoma or thyroid carcinoma. In this report we describe the case of a patient affected by PMMS and 12 yr later by a malignant brachial plexus Schwannoma and papillary thyroid carcinoma (PTC). Since both mediastinal seminoma and Schwannoma were treated with surgery followed by local radiotherapy, we were not able to ascertain if either PTC or Schwannoma had been induced by radiotherapy or represented a casual neoplastic association.
Similar content being viewed by others
References
Raghavan D. Malignant extragonadal germ cell tumours. In: Horwich A. (Ed.), Testicular cancer. Clinical investigation and management. Chapman and Hall Medical, London, New York, Melbourne, 1991, p. 297.
Oosterhius J.W., R.H., Cornelisse C.J., De Jong B., Dam A., Sleijfer D.T. Ploidy of malignant mediastinal germ cell tumors. Hum. Pathol. 1990, 2: 729–732.
Przygodzki R.M., Moran C.A., Suster S., et al. Primary mediastinal and testicular seminomas: a comparison of k-ras-2-gene sequence and p 53 immunoperoxidase analysis of 26 cases. Hum. Pathol. 1996, 2: 975–979.
Davis R.D., Oldham H.N., Sabiston D.C. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management and results. Ann. Thorac. Surg. 1987, 44: 229–237.
Brown K., Collins J.D., Batra P. Mediastinal germ cell tumor in a young woman. Med. Pediatr. Oncol. 1989, 17: 164–167.
Nichols C.R., Roth B.J., Heerema N., Griep J., Tricot G. Hematologic neoplasia associated with primary mediastinal germ cell tumors. N. Engl. J. Med. 1990, 322: 1425–1429.
Rosado de Christenson M.L., Templeton P., Moran C.A. Mediastinal germ cell tumors: radiologic and pathologic correlation. Radiographics 1992, 12: 1013–1030.
Orazi A., Neiman R.S., Ulbright T.M., Heerema N.A., John K., Nichols C.R. Hematopoietic precursor cells within the yolk sac tumor component are the source of secondary hematopoietic malignancies in patients with mediastinal germ cell tumors. Cancer 1993, 71: 3873–3881.
Hainsworth J.D., Greco F.A. Extragonadal germ cell tumors and unrecognised germ cell tumors. Semin. Oncol. 1992, 19: 119–127.
Toner G., Geller N., Shiow-Yun L., Bosl G. Extragonadal and poor risk nonseminomatous germ cell tumors. Cancer 1991, 67: 2049–2057.
Childs W.J., Goldstraw P., Nicholls J.E., Dearnaley D.P., Horwich A. Primary malignant mediastinal germ cell tumours: improved prognosis with platinum-based chemotherapy and surgery. Br. J. Cancer 1993, 67: 1098–1101.
Mead G.M., Stenning S.P., Parkinson M.C., et al. The second Medical Research Council Study of prognostic factors in nonseminomatous germ cell tumours. J. Clin. Oncol. 1992, 10: 85–94.
Goss P.E., Schwertfeger L., Blackstein M.E., et al. Extragonadal germ cell tumors. A 14 year Toronto experience. Cancer 1994, 73: 1971–1979.
Dulmet E.M., Macchiarini P., Suc B., Verley J.M. Germ cell tumors of the mediastinum. A 30-year experience. Cancer 1993, 72: 1894-1901.
Bush S.E., Martinez A., Bagshaw M.A. Primary mediastinal seminoma. Cancer 1981, 48: 1877–1882.
Nichols C.R. Mediastinal germ cell tumors. Semin. Thorac. Cardiovasc. Surg. 1992, 4: 45–50.
Ginsberg R.J. Mediastinal germ cell tumor: the role of surgery. Semin. Thorac. Cardiovasc. Surg. 1992, 4: 51–54.
Nichols C.R. Mediastinal germ cell tumor. Chest 1991, 99:472–479.
Martini N., Golbey R.B., Hajdu S.I., Whitmore W.F., Beattie E.J. Primary mediastinal germ cell tumors. Cancer 1974, 33: 763–769.
Bosl G.J., Gluckman R., Gelle N.L., et al. VAB-6: an effective chemotherapy regimen for patients with germ-cell tumors. J.Clin. Oncol. 1986: 4: 1493–1499.
Mc Leod D.G., Taylor H.G., Skoog S.J., Knight R.D., Dawson N.A., Waxman J.A. Extragonadal germ cell tumors. Clinicopathologic findings and treatment experience in 12 patients. Cancer 1988, 61: 1187–1191.
Logothetis C.J., Samuels M.L., Selig D.E., et al. Chemotherapy of extragonadal germ cell tumors. J. Clin. Oncol. 1985, 3: 316–325.
Ensinger F.M., Weiss S.W. Soft tissue tumors. C.V. Mosby, St. Louis, 1983.
Robbins J., Merino M.J., Boice J.D., et al. Thyroid cancer: a lethal endocrine neoplasm. Ann. Intern. Med. 1991, 115:133–147.
Jossart G.M., Clark O.H. Well-differentiated thyroid cancer. Curr. Probl. Surg. 1994, 31: 933–947.
Franceschi S., Boyle P., Maisonneuve P., et al. The epidemiology of the thyroid carcinoma. Crit. Rev. Oncog. 1993, 4: 25–52.
Shore R.E. Issues and epidemiological evidence regarding radiation-induced thyroid cancer. Radiat. Res. 1992, 131: 98–111.
Ron E., Kleinerman R.A., Boice J.D., Li Volsi V.A., Flannery J.T., Fraumeni J.F. Jr. A population-based case control study of thyroid cancer. J. Natl. Cancer Inst. 1987, 79: 1–12.
Schneider A.B., Recant W., Pinsky S.M., Ryo U.Y., Beckerman C., Shore Freedman. Radiation-induced thyroid carcinoma. Clinical causes and results of thyroid in 296 patients. Ann. Intern. Med. 1986, 105: 405–412.
Schneider A.B., Ron E., Lubin J., Stovall M., Gierlowski T.C. Dose-response relationships for radiation-induced thyroid cancer and thyroid nodules: evidence for the prolonged effects of radiation on the thyroid. J. Clin. Endocrinol. Metab. 1993, 77: 362–369.
Boice J.D. Jr, Engholm G., Kleinerman R.A., et al. Radiation dose and second cancer risk in patients treated for cancer of the cervix. Radiat. Res. 1988, 116: 3–55.
Kazakov U.S., Demidchik E.P., Astakhova L.N. Thyroid cancer after Chernobyl. Nature 1992, 21: 359.
Pacini F., Vorontosova T., Demidchik E.P., et al. Post-Chernobyl thyroid carcinoma in Belarus children and adolescents: comparison with naturally occurring thyroid carcinoma in Italy and France. J. Clin. Endocrinol. Metab. 1997, 82: 3563–3569.
Schlumberger M.J. Papillary and follicular thyroid carcinoma. N. Engl. J. Med. 1998, 338: 297–306.
Stratakis C.A., Kirschner L.S., Taymans S.E., et al. Carney complex, Peutz-Jeghers syndrome, Cowden disease and Bannayan-Zonana syndrome share cutaneous and endocrine manifestations but not genetic loci. J. Clin. Endocrinol. Metab. 1998, 83: 2972–2976.
Giardiello F.M., Welsh S.B., Hamilton S.R., et al. Increased risk of cancer in the Peutz-Jeghers Syndrome. N. Engl. J. Med. 1987, 316: 1511–1514.
Hizawa K., Iida M., Matsumoto T., et al. Cancer in Peutz-Jeghers syndrome. Cancer 1993, 72: 2777–2781.
Young S., Gooneratne S., Straus F.H., Zeller W.P., Bulun S.E, Rosenthal I.M. Feminizing Sertoli cell tumours in boys with Peutz-Jeghers syndrome. Am. J. Surg. 1995, 19: 50–58.
Liaw D., Marsh D.J., Li J., et al. Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome. Nat. Genet. 1997, 16: 64–67.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Appetecchia, M., Pucci, E. A rare association between malignant mediastinal seminoma and other malignant neoplasms. J Endocrinol Invest 25, 373–376 (2002). https://doi.org/10.1007/BF03344021
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03344021