PMC6590609_01
A large mediastinal mass is noted on MRI before surgery.
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In addition, a chest MRI was performed and it showed a well-defined, lobulated, and heterogeneous anterior mediastinal mass measuring 15.9 x 15 x 14.5 cm occupying the right hemithorax (Figure 1).
The resected tumor next to a 30 cm ruler.
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Four courses of VIP chemotherapy were given, and then a midline sternotomy with a resection of the large anterior mediastinal mass was done (Figure 2).
The cut surface of the mediastinal tumor is grey-white in appearance with areas of hemorrhage, necrosis, and cystic changes.
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Areas of necrosis, hemorrhage, and cystic spaces filled with mucoidal material were noted (Figure 3).
Low-power view of the tumor showing islands of mature cartilage, dilated blood vessels, and epithelial cysts within spindle stroma (H&E stain).
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The differentiated component showed a mature teratoma composed of mature cartilage, bone trabeculae, smooth muscle fibers, and respiratory and gastric-type epithelia, while the undifferentiated component showed features of a yolk sac tumor containing hepatoid elements, proliferated sarcomatous spindle cells, and an increased mitotic rate (Figures 4-6).
Image shows tumor composed of a mixture of epithelial cysts with papillary projections and squamous morules with sarcomatous stromal components (H&E stain).
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The differentiated component showed a mature teratoma composed of mature cartilage, bone trabeculae, smooth muscle fibers, and respiratory and gastric-type epithelia, while the undifferentiated component showed features of a yolk sac tumor containing hepatoid elements, proliferated sarcomatous spindle cells, and an increased mitotic rate (Figures 4-6).
Image shows high-power microscopic appearance of the nonseminomatous germ cell tumor with sarcomatous changes (H&E stain).
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The differentiated component showed a mature teratoma composed of mature cartilage, bone trabeculae, smooth muscle fibers, and respiratory and gastric-type epithelia, while the undifferentiated component showed features of a yolk sac tumor containing hepatoid elements, proliferated sarcomatous spindle cells, and an increased mitotic rate (Figures 4-6).
CT scan follow-up postresection of tumor.
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In addition, follow-up CT scan showed no residual tumor postresection (Figure 7).