Intra-arterial chemotherapy with cis-diamminedichloroplatinum (CDDP) for primary mediastinal seminoma

Primary mediastinal malignant germinoma is a rare disease, and only about 15 patients have been reported in Japan. We treated a patient with this disease by intra-arterial CDDP infusion and observed good effects. A 29 year-old male was admitted to our hospital due to SVC syndrome in 1980. A right mediastinal tumor was detected, and the resection of this tumor was performed. Histological examination showed seminoma. Though postoperative Co irradiation was performed, radiation pneumonitis developed in the right lung. Subsequently, the tumor metastasized to the right kidney and spinal cord. After removal of the right kidney followed by Co irradiation, the clinical course was good. In 1987, a mass (10 x 6 cm) was detected in the left mediastinum, suggesting recurrence. Four courses of CDDP infusion into the left bronchial artery and left internal thoracic artery (1 course: 45-70 mg) were performed, and good effects were obtained. No side effects were observed, and the clinical course has been good until now. This case is of interest in evaluating the multidisciplinary treatment for mediastinal seminoma.