METHODS: Clinicopathological data of the patients with primary mediastinal
yolk sac tumor who received operation in Peking University First Hospital between August 2014 and August 2018 were collected and analyzed retrospectively.
RESULTS: We experienced seven primary mediastinal
yolk sac tumors during this period. Computed tomography scan revealed an anterior mediastinal
tumor in all the patients and all of them had markedly raised alphafetoprotein (AFP) and normal β-human chorion
gonadotropin (β-HCG). Five patients underwent needle core biopsy before treatment, which showed a mediastinal
yolk sac tumor. All of these patients received preoperative
platinum-based
chemotherapy and they all presented partial response according to computed tomography. Two other patients did not receive preoperative biopsy, so they directly underwent extended resection. All of the seven patients underwent operation successfully and two of them experienced postoperative complications, including one with
pneumonia and the other with
atelectasis. R0 resection was achieved in six patients and R1 resection was achieved in the other patient. According to postoperative pathology, there were one microcyst subtype, one adenoid subtye, one giant
capsule subtype and two hybrid subtypes. Surprisingly, there were no
yolk sac tumor tissue in the other two patients after preoperative
chemotherapy. All the patients received postoperative
chemotherapy, excluded one patient who was unable to tolerate
chemotherapy after operation. Three patients experienced postoperative pulmonary
metastases within one year and two of them died soon. The other patient received
chemotherapy and
immunotherapy after recurrence and he was alive at the time of writing. Four other patients were alive without recurrence and
metastasis.
CONCLUSION: