内容紹介
A Case of Mediastinal Growing Teratoma Syndrome with Acute Megakaryoblastic Leukemia
Summary
We report a case of a 38-year-old man who was diagnosed with a mediastinal germ cell tumor. After induction chemotherapy, the tumor marker levels normalized, but the tumor itself continued to grow. Surgical resection was performed successfully, but the patient developed acute megakaryoblastic leukemia 6 months later, and induction and consolidation therapies failed to achieve remission. Leukemia cells invaded the central nervous system following hematopoietic stem cell transplantation, and the patient died 5 months after being diagnosed with leukemia. This very rare case of a mediastinal germ cell tumor met the criteria for“growing teratoma syndrome”, against a background of acute megakaryoblastic leukemia.
要旨
症例は38歳,男性。縦隔胚細胞腫瘍に対してbleomycin+etoposide+cisplatin(BEP)療法を施行し,腫瘍マーカーは正常化するも腫瘍は増大した。外科的切除を行ったが,術後半年で急性巨核芽球性白血病を併発した。寛解導入療法,地固め療法を行うも寛解に至らず,造血幹細胞移植後に白血病の中枢神経浸潤を来し,白血病発症後5か月で永眠された。縦隔胚細胞腫瘍のうち,growing teratoma syndromeの定義を満たし,かつ急性巨核芽球性白血病を併発する例は極めてまれであり,若干の文献的考察を加えて報告する。
目次
Summary
We report a case of a 38-year-old man who was diagnosed with a mediastinal germ cell tumor. After induction chemotherapy, the tumor marker levels normalized, but the tumor itself continued to grow. Surgical resection was performed successfully, but the patient developed acute megakaryoblastic leukemia 6 months later, and induction and consolidation therapies failed to achieve remission. Leukemia cells invaded the central nervous system following hematopoietic stem cell transplantation, and the patient died 5 months after being diagnosed with leukemia. This very rare case of a mediastinal germ cell tumor met the criteria for“growing teratoma syndrome”, against a background of acute megakaryoblastic leukemia.
要旨
症例は38歳,男性。縦隔胚細胞腫瘍に対してbleomycin+etoposide+cisplatin(BEP)療法を施行し,腫瘍マーカーは正常化するも腫瘍は増大した。外科的切除を行ったが,術後半年で急性巨核芽球性白血病を併発した。寛解導入療法,地固め療法を行うも寛解に至らず,造血幹細胞移植後に白血病の中枢神経浸潤を来し,白血病発症後5か月で永眠された。縦隔胚細胞腫瘍のうち,growing teratoma syndromeの定義を満たし,かつ急性巨核芽球性白血病を併発する例は極めてまれであり,若干の文献的考察を加えて報告する。