Primary Seminoma Localized in Mediastinum: Case Report

  • Deva Petrova Acibadem Sistina Hospital, Skopje, Republic of Macedonia
  • Slavica Kraleva Acibadem Sistina Hospital, Skopje, Republic of Macedonia
  • Lilijana Muratovska Acibadem Sistina Hospital, Skopje, Republic of Macedonia
  • Biljana Crcareva Acibadem Sistina Hospital, Skopje, Republic of Macedonia
Keywords: Mediastinum, Seminoma, Chemotherapy, Radiotherapy


BACKGROUND: Primary mediastinal seminomas most commonly occur in young men, and they are localised in the anterior mediastinum.

CASE PRESENTATION: The presented study is a case report of a 34-year-old man suffering from a mediastinal tumour in size of 19 cm, with pleural and pericardial effusion. The patient complains of cough, difficulty breathing, weight loss, and pronounced tiredness. CT of lungs and biopsy of the mediastinal change was performed. The histopathological analysis was in favour of a primary mediastinal seminoma. The patient initially had pronouncedly increased levels of LDH and β-hCG tumour marker. Pericardiocentesis was realised due to threatening tamponade of the heart, followed by 4 cycles of chemotherapy by BEP protocol. Following 2 cycles of chemotherapy, normalisation of LDH and β-HCG levels and significantly improved the clinical condition in the patient was found. Upon completion of 4 chemotherapy cycles by BEP protocol, the patient performed an FDG-PET scan with partial response and reduced dimension of a primary tumour in the mediastinum. Radiotherapy of residual tumour mass up to a total dose of 40Gy in 20 fractions was realised. Control FDG-PET scan had a finding of complete response to a tumour and absence of FDG uptake. The last follow-up examination was performed in October 2018, and the patient was disease-free for 54 months.

CONCLUSION: Multimodality treatment approach of chemotherapy followed by radiation consolidation ensured long-term survival in primary advanced mediastinal seminoma.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Hainsworth JD, Greco FA. Germ cell neoplasms and other malignancies of the mediastinum. Cancer Treat Res. 2001; 105:303–325.

Bokemeyer C , Nichols CR , Droz JP , et al Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis. J Clin Oncol. 2002; 20:1864–73. PMid:11919246

Takeda S, Miyoshi S, Ohta M, Minami M, Masaoka A, Matsuda H. Primary germ cell tumors in the mediastinum: a 50-year experience at a single Japanese institution. Cancer. 2003; 97:367–376. PMid:12518361

Busch J, Seidel C , Zengerling F Male extragonadal germ cell tumors of the adult. Oncol Res Treat. 2016; 39:140–4. PMid:27032104

McKenney JK, Heerema-McKenney A, Rouse RV. Extragonadal germ cell tumors: A review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations. Adv Anat Pathol. 2007; 14:69–92. PMid:17471115

Gilligan TD, Hayes DF, Seidenfeld J, Temin S. ASCO clinical practice guideline on uses of serum tumor markers in adult males with germ cell tumors. Journal of oncology practice. 2010; 6(4):199-202. PMid:21037873 PMCid:PMC2900872

Liu TZ, Zhang DS, Liang Y, Zhou NN, Gao HF, Liu KJ, Wu HY. Treatment strategies and prognostic factors of patients with primary germ cell tumors in the mediastinum. Journal of cancer research and clinical oncology. 2011; 137(11):1607. PMid:21850383 PMCid:PMC3193517

Feldman DR, Patil S, Trinos MJ, Carousso M, Ginsberg MS, Sheinfeld J, Bajorin DF, Bosl GJ and Motzer RJ: Progression-free and overall survival in patients with relapsed/refractory germ cell tumors treated with single-agent chemotherapy: Endpoints for clinical trial design. Cancer. 2012; 118: 981-986. PMid:21792865

Huang J, Tan Y, Zhen Z, Lu S, Sun F, Zhu J, et al. Role of post-chemotherapy radiation in the management of children and adolescents with primary advanced malignant mediastinal germ cell tumors. PLoS One. 2017; 12(8):e0183219. PMid:28813488 PMCid:PMC5558937

How to Cite
Petrova D, Kraleva S, Muratovska L, Crcareva B. Primary Seminoma Localized in Mediastinum: Case Report. Open Access Maced J Med Sci [Internet]. 2019Jan.25 [cited 2021Jan.24];7(3):384-7. Available from:
C- Case Reports