Yuvi’s illness: Mediastinal Seminoma

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According to sources, Yuvraj Singh had earlier been diagnosed as Non Hodgkin’s Lymphoma and later confirmed to be a case of mediastinal seminoma.

• Mediastinal seminomas constitute 33% of malignant mediastinal germ cell tumors (GCTs) and 2 to 4 percent of mediastinal masses.
• They occur predominantly in men between the ages of 20 and 40
• It is uncommon for testicular seminoma to metastasize to the mediastinum in the absence of retroperitoneal lymph node involvement. But the same should be ruled out in all cases. Testes are removed if that is the case.
• Primary mediastinal seminomas are typically slow growing and can be very bulky by the time they cause discomfort.
• 75% are symptomatic at the time of diagnosis.
• Symptoms include chest pain (39%), dyspnea (29%), cough (22%), weight loss (19%), superior vena cava syndrome (12%), fever (6%) and nausea (6%).
• Serum beta-hCG is elevated in approximately one-third of patients.
• These tumors do not secrete AFP.
• Majority of mediastinal seminomas have metastasized by the time they are detected, most often to the lymph nodes and less commonly to lungs, bone, and/or liver.
• Presence of nonpulmonary visceral metastases is associated with a poorer prognosis.
• Seminomas are exquisitely sensitive to both cisplatin-based chemotherapy and RT, regardless of location.
• Mediastinal seminomas are classified as good-risk GCTs by the International Germ Cell Consensus Classification unless nonpulmonary visceral metastases are present.
• They have a five-year survival rate of greater than 90%.
• Most prefer chemotherapy to RT for patients with mediastinal seminoma.
• Recommended chemotherapy regimen for patients with mediastinal seminomas and no nonpulmonary visceral metastases is three cycles of cisplatin, etoposide, plus bleomycin (BEP) chemotherapy or four cycles of etoposide plus cisplatin.
• Following chemotherapy, many patients are left with a residual mass. (Source Uptodate.com)