P0313 PRIMARY CERVICAL SPINE OSTEOSARCOMA PRESENTING AS VOLUMINOUS MEDIASTINAL TUMOR

Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283

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P0314

P0312 MEDIASTINAL SEMINOMA: IN REFERENCE TO A CASE REPORT 1

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Filipa Gândara , Manuela Bernardo , Maria Manuel Noronha , Beisan Beseisso 1 , J Sena Lino 2 , Sância Ramos 2 , Isabel João 1 , Fátima Ceia 1 . 1 Serviço De Medicina Iii, Hospital De São Francisco Xavier, Centro Hospitalar Lisboa Ocidental; 2 Centro Hospitalar Lisboa Ocidental Introduction: Primary mediastinal seminoma is an uncommon tumor that usually appears in the anterior mediastinum. The disease usually develops in the third or fourth decade of life in males.The symptoms are usually cough, chest pain and/or dyspnea. Case report: The authors describe a case of a caucasian 37-year-old man, with smoking habits, overweight, arterial hypertension and dyslipidemia, who was admitted for posterior cervical pain with retrosternal chest irradiation, with no other complains. A physical examination revealed hypertension (158/112mmHg), auscultatory mumur at right hemithorax apex diminution, and no palpable periphery lymph nodes. Specific laboratory studies revealed troponin >0,05 ug/L; LDH- 1016U/L; B-HCG- 26,7 U/L; AFP- 1,80ng/ml and B2-microglobulin- 1,7mg/L. A chest X-ray film showed an abnormal left shadow in the superior mediastinum confirmed by thoracic computerized tomography (CT), which revealed the presence of a volumous mediastinum, polilobulated, well defined borders, homogeneous mass, with invasion signs. Abdominal, pelvis and cerebral CT had no other lesions. Thoracotomy was performed and histological study led to a mediastinal seminoma diagnosis. Testicular sonography had ruled out primary tumor. The patient was treated with four cycles of bleomycin, ectoposide and cisplatinum (BEP) with complete tumor imaging remission and B-HCG level normalization (