Mediastinal seminoma presenting with superior vena cava syndrome

BMJ Case Rep. 2017 Jun 8:2017:bcr2016218282. doi: 10.1136/bcr-2016-218282.

Abstract

We present a rare cause of superior vena cava syndrome (SVC) in a previously healthy male aged 31 years. Malignancy was suspected due to unintentional weight loss and childhood exposure to radioactive fallout from a nuclear facility accident. A very large anterior mediastinal mass was identified and demonstrated to be an extragonadal seminoma. Extragonadal germ cell tumours are rare tumours with a high potential for cardiovascular, pulmonary and vascular sequelae. Studies have documented an increased risk of developing seminoma in patients with radioactive exposure. Chemotherapy was initiated, during which the patient experienced progressive and new symptoms, found to be due to extensive thromboembolic disease, which responded well to anticoagulation. Seventy-two months after completing chemotherapy, without need for surgical management, he remains free of the disease.

Keywords: cancer - see oncology; cancer intervention.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Diagnosis, Differential
  • Humans
  • Incidence
  • Male
  • Mediastinal Neoplasms / diagnostic imaging
  • Mediastinal Neoplasms / pathology*
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Radioactive Fallout / adverse effects
  • Seminoma / complications
  • Seminoma / drug therapy
  • Seminoma / epidemiology
  • Seminoma / pathology*
  • Superior Vena Cava Syndrome / complications*
  • Superior Vena Cava Syndrome / diagnostic imaging
  • Superior Vena Cava Syndrome / etiology*
  • Thromboembolism / complications
  • Thromboembolism / drug therapy
  • Thromboembolism / etiology
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Anticoagulants
  • Radioactive Fallout