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Reminder of important clinical lesson
CASE REPORT
Mediastinal seminoma presenting with superior vena cava syndrome
  1. Amanda Wanous1,
  2. Ian R McPhail2,
  3. J Fernando Quevedo3,
  4. Nicole P Sandhu4
  1. 1Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
  2. 2Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
  3. 3Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
  4. 4Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Nicole P Sandhu, sandhu.nicole{at}mayo.edu

Summary

We present a rare cause of superior vena cava syndrome (SVC) in a previously healthy male aged 31 years. Malignancy was suspected due to unintentional weight loss and childhood exposure to radioactive fallout from a nuclear facility accident. A very large anterior mediastinal mass was identified and demonstrated to be an extragonadal seminoma. Extragonadal germ cell tumours are rare tumours with a high potential for cardiovascular, pulmonary and vascular sequelae. Studies have documented an increased risk of developing seminoma in patients with radioactive exposure. Chemotherapy was initiated, during which the patient experienced progressive and new symptoms, found to be due to extensive thromboembolic disease, which responded well to anticoagulation. Seventy-two months after completing chemotherapy, without need for surgical management, he remains free of the disease.

  • cancer - see oncology
  • cancer intervention

https://doi.org/10.1136/bcr-2016-218282

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    Footnotes

    • Contributors AW contributed fully to the clinical data acquisition and analysis and to the authorship of this manuscript. NPS, JFQ and IRMP were directly involved in the clinical evaluation and care of the patient described in this case report. NPS developed the concept of this case report, and contributed fully to clinical data acquisition and analysis and authorship of the manuscript. JFQ and IRMP contributed to clinical data analysis relevant to their areas of clinical expertise and contributed fully to the authorship of the manuscript. All authors have read and approved of the manuscript in its entirety.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.