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Page 26 of 38 J Cancer Metastasis Treat 2020;6:5 I http://dx.doi.org/10.20517/2394-4722.2020.13

36. Giant mediastinal mixed germ cell tumor, a rare case report and review of literature

Abdulrahman Hakami

Jazan University, Jazan 45142, KSA.

Introduction: Germ cell tumors are relatively rare, embryologically-derived from reproductive cells, and
usually arise in the gonads. Mediastinal germ cell tumors are estimated to be about 1%-3% of all germ cell
tumors and are generally seen in the anterior mediastinum, while metastatic lesions are mostly seen in the
posterior mediastinum. The most aggressive germ cell tumor subtypes are choriocarcinoma, embryonal
carcinoma, and yolk-sac tumors. Seminomas only rarely spread distantly. The presentations vary, ranging
from accidental findings on routine radiography to life-threatening respiratory and cardiovascular
compromise, which can also present as gigantic intrathoracic germ cell tumors, as in our case.

Case report: A 30-year-old male patient, not known to have any chronic illness, was referred from TB
hospital center due to history of dyspnea, cough, and loss of appetite with weight loss for more than four
months and no history of chest pain or hemoptysis. Chest X-ray was performed and showed complete
obliteration of the right side of thorax; pleural effusion was suspected, and pleural TB and empyema
were diagnosed. He was started on a tuberculosis drugs, antibiotics, and received chest drain with a
slightly bloody fluid. Patient did not improve and was referred to our hospital. Computed hospital of
chest with contrast revealed a very large mass obliterating the right side of chest, pushing the trachea and
mediastinum to the left side with minimal effusion on both sides. Pleural US revealed mass and effusion
but no empyema. Differential diagnosis was mediastina mass, adenocarcinoma, thymic carcinoma,
lymphomas, fibroma, or fibrosarcoma. US guided transthoracic fine needle biopsy from the right-side mass
revealed mixed germ cell tumor. The patient’s condition had rapidly deteriorated prior to confirming the
diagnosis or starting with treatments and died because of difficult airway breathing due to deviated and
compressed airway and possible pneumothorax after transthoracic biopsy.

Conclusion: Germ cell tumors are aggressive and rapidly growing cancers. The literature reports the nature
of the extragonadal mediastinal germ cell tumor as appearing as a giant mass occluding the whole lung,
compressing the great vessels, and adhering to the chest wall, pericardium, and lung, as in our case. This
leads to a worse prognosis. The estimated event-free survival at 10 years after combined treatment is 80.4%.
Chemotherapy, debulking, and pneumoctomy are the treatments for such cases.

37. MGMT, BRCA1 and MEG3 methylation status in triple-negative breast cancer

4
1
1
Sylwia Paszek , Agnieszka Kołacińska , Marcin Braun , Ewa Kaznowska , Dorota Jesionek-
2,3
4
1
Kupnicka , Edyta Barnaś , Izabela Zawlik 1
1 Faculty of Medicine, University of Rzeszow, Kopisto 2a, Rzeszow 35-959, Poland.
2 Department of Head and Neck Cancer Surgery, Medical University of Lodz, Paderewskiego 4, Lodz 93-509,
Poland.
3 Breast Unit, Cancer Center, Copernicus Memorial Hospital, Pabianicka 62, Lodz 93-513, Poland.
4 Department of Pathology, Chair of Oncology, Medical University of Lodz, Paderewskiego 4, Lodz 93-509,
Poland.

Background and aim: Breast cancer is one of the most common cancers in women worldwide. The most
severe type of breast cancer is triple-negative breast cancer (TNBC) due to unfavorable clinical course