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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Malignant histiocytosis associated with mediastinal germ cell tumor: A case report
Pei-Yi Yang, Xiao-Li Ma, Wen Zhao, Li-Bing Fu, Rui Zhang, Qi Zeng, Hong Qin, Tong Yu, Yan Su
Pei-Yi Yang, Xiao-Li Ma, Wen Zhao, Yan Su, Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
Li-Bing Fu, Department of Pathology, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China
Rui Zhang, Hematology Center, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China
Qi Zeng, Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Hong Qin, Department of Surgical Oncology, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
Tong Yu, Department of Image Center, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China
Author contributions: Yang PY, Ma XL and Zhao W were the patient’s oncology physicians, reviewed the literature, and contributed to manuscript drafting; Fu LB analyzed the pathological findings; Zhang R contributed to the patient’s treatment for malignant histiocytosis; Zeng Q and Qin H were the patient’s surgeons; Yu T interpreted the imaging findings; Su Y was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed consent was obtained from the patient’s parents.
Conflict-of-interest statement: The authors have no conflicts of interest relevant to this article to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yan Su, MM, Chief Physician, Department of Medical Oncology, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 South Lishi Road, Beijing 100045, China. suyanbch@sina.com
Received: December 31, 2021
Peer-review started: December 31, 2021
First decision: February 14, 2022
Revised: February 28, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: July 16, 2022
BACKGROUND
Germ cell tumors (GCTs) account for 2% of human malignancies but are the most common malignant tumors among males aged 15-35. Since 1983, an association between mediastinal GCT (MGCT) and hematologic malignancies has been recognized.
CASE SUMMARY
We report a case in which malignant histiocytosis was associated with mediastinal GCTs. The clinical data of a male patient with MGCT admitted to Beijing Children's Hospital were collected retrospectively. The patient was first diagnosed according to imaging and pathological features as having MGCT, and was treated with surgery and chemotherapy. One year after stopping chemotherapy, imaging showed metastases in the right supraclavicular, mediastinum, hilar region and retroperitoneal lymph node, right pleura, right lung, and right para-cardiac margin. Pathological diagnosis of the liver nodular and hilar lymph nodes included systemic juvenile xanthogranuloma and Rosai-Dorfman lesions with malignant transformation (i.e., morphological characteristics and immunophenotype of histiocytic sarcoma). Following diagnosis, the patient accepted chemotherapy with vindesine, cytarabine and dexamethasone. Positron emission tomography–computed tomography showed partial remission. The patient was followed-up for 10 mo after the diagnosis of malignant histiocytosis, and no sign of progression or relapse was observed.
CONCLUSION
Physicians should recognize the possibility of hematologic malignancies being associated with MGCT. Suitable sites should be selected for pathological examination.
Core Tip: Association between mediastinal germ cell tumor (MGCT) and hematologic malignancies has been recognized. We report a case in which the malignant histiocytosis were associated with MGCT. The patient was diagnosed as MGCT first, and one year after stopping chemotherapy, imaging showed metastases in mediastinum, retroperitoneal lymph node and adjacent tissues. Then he was diagnosed as malignant histiocytosis according to pathological examination, and accepted chemotherapy. The patient has been followed up for 10 mo with no sign of progression or relapse. Physicians who take care of patients with MGCT should be aware of the possibilities of associated hematologic malignancies.
