ABSTRACT Introduction Primary mediastinal non‐seminomatous germ cell tumors (PMNSGCTs) are rare and aggressive neoplasms that carry a poor prognosis, especially following salvage chemotherapy. In cases of residual tumors with elevated tumor marker levels, desperation surgery may be considered. Case Presentation A 32‐year‐old man with PMNSGCT presented with a 100‐mm anterior mediastinal mass and elevated alpha‐fetoprotein (AFP; 17 000 ng/mL). After induction and salvage chemotherapy, AFP levels decreased to 20 ng/mL but did not normalize, and a 55‐mm cystic tumor persisted. Desperation surgery was performed despite an increase in AFP (40 ng/mL) before the operation. The tumor was completely resected, and histopathological examination revealed no viable tumor cells or teratomas. Postoperatively, AFP normalized, and the patient has remained recurrence‐free. Conclusion This case highlights the potential role of desperation surgery in achieving long‐term survival in selected patients with PMNSGCT, despite increased levels of tumor markers.
Aigase et al. (Sun,) studied this question.
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