縦隔Ｙｏｌｋ　ｓａｃ　ｔｕｍｏｒの１手術例

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  • A resected case of yolk sac tumor of the mediastinum.

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Yolk sac tumor of the mediastinum is relatively rare. Thirty four cases were collected from the Japanese literature by the author. A 30 year-old male patient with an enlarged abnormal shadow of the anterior mediastinum extending to the left lung field was admitted. On admission, the serum alpha fetoprotein (AFP) level increased to 19, 000 ng/ml and the LDH level increased to 1078 IU/1. The clinical diagnosis was malignant germ cell tumor, and through a median sternotomy, the tumor which infiltrated the pericardium, left upper lobeand left pulmonary artery was removed completely with combined left pneumonectomy and partialresection of the pericardium on October 25, 1984. Serum AFP and LDH levels decreased rapidly after the surgery. Histologic examination showed a pure type of yolk sac tumor. The result of an immunopathological study using the PAP method showed a positive localization of AFP granules in tumor cells forming endodermal sinus structures. Postoperative irradiation with 3300 rads in total and chemotherapy with Vincristine, Cyclophosphamide, 5FU and MMC have been carried out. The re-elevation of serum AFP and LDH levels was associated with metastasis to the right lung and the cervical lymph nodes. The patient was treated conservatively until April 18, 1985 when he expired.

収録刊行物

  • 肺癌

    肺癌 26 (3), 333-338, 1986

    特定非営利活動法人 日本肺癌学会

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