Secondary malignant melanoma in primary mediastinal germ cell tumour

• Published in: Journal of the Pakistan Medical Association Vol. 65; no. 1; pp. 98 - 100
• Main Authors: Hannan, Abdul, Akhter, Noreen, Kazmi, Ather Saeed, Muzaffar, Narjis
• Format: Journal Article
• Language: English
• Published: Pakistan Knowledge Bylanes 01.01.2015
• Subjects: Adult; Chemotherapy; Diagnosis; Fatal Outcome; Humans; Male; Mediastinal Neoplasms - pathology; Melanoma; Melanoma - pathology; Melanoma, Cutaneous Malignant; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Second Primary - pathology; Skin Neoplasms; Tumors
• ISSN: 0030-9982

Secondary transformation in Germ Cell Tumours (GCT) is an extremely rare event. We report here a case of malignant melanoma arising in primary mediastinal GCT. A young male presented with new onset dyspnoea and a mediastinal mass. As serum alpha fetoprotein was raised, a diagnosis of primary mediastinal GCT was made. He achieved remission with standard chemotherapy and resection of the mass. After a year, he relapsed with widespread disease which on work-up revealed malignant melanoma. As examination for cutaneous melanoma was unremarkable, a diagnosis of mediastinal GCT with secondary transformation to melanoma was made. Exact origin of melanoma in GCTs is unknown, but these may occur from transformation of dermal elements or de-differentiation of germ cells to melanomas. Before making such a diagnosis, search for primary cutaneous melanoma is mandatory. No clear guidelines exist in literature for the treatment of secondary melanomas, so current management guidelines for cutaneous melanoma may be followed.