Primary mediastinal seminoma

Abstract

Objective: To describe the diagnosis, and therapeutic management of a patient with extragonadal seminoma of mediastinal origin, highlighting the specificities in the approach to this rare type of tumor. Case details: The case describes a man with mediastinal seminoma, presenting with dyspnea, chest pain, and dysphagia. Computed tomography revealed an extensive mediastinal mass, while immunohistochemistry confirmed metastatic seminoma. Oncology treatment followed the BEP regimen (Bleomycin, Etoposide, and  Cisplatin) for four cycles. The patient completed all four chemotherapy cycles with good tolerance, achieving significant tumor mass reduction and symptom improvement, despite persistent bone and pleural lesions. One year after diagnosis, the patient is asymptomatic, awaiting therapeutic decisions. Final considerations: The patient received standard therapy for seminomas, in accordance with the European Society for Medical Oncology, which recommends polychemotherapy with bleomycin, etoposide, and cisplatin. Three cycles are suggested for patients with a good prognosis and four cycles for those with an intermediate prognosis. Finally, the favorable response to cisplatin-based chemotherapy observed aligns with the recommended first-line treatment for seminomas.