Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review
Abstract Germ cell tumours with somatic-type solid malignancy (GCT-STM) are a rare disease of the mediastinum. Recently, a cohort of vasculogenic mesenchymal tumour (VMT)-nonseminoma cases with different prognoses were recognized and reported. Here, we report a case of mediastinal high-grade VMT wit...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Diagnostic Pathology |
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| Online Access: | https://doi.org/10.1186/s13000-023-01333-9 |
| _version_ | 1797836636441018368 |
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| author | Shang Zhanxian Han Yuchen Wei Jinzhi Zhu Lei |
| author_facet | Shang Zhanxian Han Yuchen Wei Jinzhi Zhu Lei |
| author_sort | Shang Zhanxian |
| collection | DOAJ |
| description | Abstract Germ cell tumours with somatic-type solid malignancy (GCT-STM) are a rare disease of the mediastinum. Recently, a cohort of vasculogenic mesenchymal tumour (VMT)-nonseminoma cases with different prognoses were recognized and reported. Here, we report a case of mediastinal high-grade VMT with a seminoma. A 16-year-old male had a fever, chest tightness and fatigue. Chest CT showed a 7.5 cm×5.3 cm solid mass in the right anterior mediastinum. The serum levels of alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-HCG) and carcinoembryonic antigen (CEA) were within the normal range. Tumorectomy was performed. The tumour was irregular, and no capsule was found. The cut surface was greyish white and greyish brown with medium consistency. There were foci of bleeding and necrosis. Microscopic histology showed prominent vascular proliferation, which was lined by mildly atypical endothelial cells in a cellular stroma with significant cytologic atypia. The vascular spectrum varied from crevice-like or antler-like thin- to thick-walled vessels. Beyond the tumour area, inside the remnant thymus tissues, there were small clusters of polygonal tumour cells with clear cytoplasm, distinct cell membranes, and round to polygonal nuclei with prominent nucleoli that were positive for Oct4, PLAP, SALL4 and CD117. The patient did not receive any treatments pre- or postoperation, and his condition was stable without progression after 14 months of follow-up evaluation. Here, we added a new entity of GCT-STM of the mediastinum composed of VMT and seminoma. A better understanding of the pathological features of GCT-VMT could help pathologists improve their awareness of these rare diseases. |
| first_indexed | 2024-04-09T15:13:13Z |
| format | Article |
| id | doaj.art-b532f576e7d245fdb8b1afa1b3eb95df |
| institution | Directory Open Access Journal |
| issn | 1746-1596 |
| language | English |
| last_indexed | 2024-04-09T15:13:13Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Diagnostic Pathology |
| spelling | doaj.art-b532f576e7d245fdb8b1afa1b3eb95df2023-04-30T11:05:46ZengBMCDiagnostic Pathology1746-15962023-04-011811510.1186/s13000-023-01333-9Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature reviewShang Zhanxian0Han Yuchen1Wei Jinzhi2Zhu Lei3Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of MedicineAbstract Germ cell tumours with somatic-type solid malignancy (GCT-STM) are a rare disease of the mediastinum. Recently, a cohort of vasculogenic mesenchymal tumour (VMT)-nonseminoma cases with different prognoses were recognized and reported. Here, we report a case of mediastinal high-grade VMT with a seminoma. A 16-year-old male had a fever, chest tightness and fatigue. Chest CT showed a 7.5 cm×5.3 cm solid mass in the right anterior mediastinum. The serum levels of alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-HCG) and carcinoembryonic antigen (CEA) were within the normal range. Tumorectomy was performed. The tumour was irregular, and no capsule was found. The cut surface was greyish white and greyish brown with medium consistency. There were foci of bleeding and necrosis. Microscopic histology showed prominent vascular proliferation, which was lined by mildly atypical endothelial cells in a cellular stroma with significant cytologic atypia. The vascular spectrum varied from crevice-like or antler-like thin- to thick-walled vessels. Beyond the tumour area, inside the remnant thymus tissues, there were small clusters of polygonal tumour cells with clear cytoplasm, distinct cell membranes, and round to polygonal nuclei with prominent nucleoli that were positive for Oct4, PLAP, SALL4 and CD117. The patient did not receive any treatments pre- or postoperation, and his condition was stable without progression after 14 months of follow-up evaluation. Here, we added a new entity of GCT-STM of the mediastinum composed of VMT and seminoma. A better understanding of the pathological features of GCT-VMT could help pathologists improve their awareness of these rare diseases.https://doi.org/10.1186/s13000-023-01333-9Vasculogenic mesenchymal tumourseminomaGerm cell tumours with somatic-type solid malignancyMorning glory syndrome. |
| spellingShingle | Shang Zhanxian Han Yuchen Wei Jinzhi Zhu Lei Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review Diagnostic Pathology Vasculogenic mesenchymal tumour seminoma Germ cell tumours with somatic-type solid malignancy Morning glory syndrome. |
| title | Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review |
| title_full | Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review |
| title_fullStr | Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review |
| title_full_unstemmed | Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review |
| title_short | Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review |
| title_sort | mediastinal high grade vasculogenic mesenchymal tumour with seminoma a case report and literature review |
| topic | Vasculogenic mesenchymal tumour seminoma Germ cell tumours with somatic-type solid malignancy Morning glory syndrome. |
| url | https://doi.org/10.1186/s13000-023-01333-9 |
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