Surgical resection after BEP therapy induced interstitial pneumonia during treatment for primary mediastinal malignant germ cell tumor

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  • Kawakita Naoya
    Department of Thoracic, Endocrine Surgery and Oncology, The University of Tokushima Graduate School Department of Surgery, Tokushima Prefectural Central Hospital
  • Sakiyama Shoji
    Department of Thoracic, Endocrine Surgery and Oncology, The University of Tokushima Graduate School
  • Toba Hiroaki
    Department of Thoracic, Endocrine Surgery and Oncology, The University of Tokushima Graduate School
  • Takizawa Hiromitsu
    Department of Thoracic, Endocrine Surgery and Oncology, The University of Tokushima Graduate School
  • Hirose Toshiyuki
    Department of Surgery, Tokushima Prefectural Central Hospital

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  • 縦隔原発悪性胚細胞性腫瘍に対するBEP療法中に発症した間質性肺炎治療後に手術を施行した2例

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Abstract

<p>The incidence of interstitial pneumonia caused by bleomycin is increasing, dependent on the total dose. Care should be taken in the treatment of a germ cell tumor requiring high-dose administration. If interstitial pneumonia occurs during treatment for a primary mediastinal malignant germ cell tumor, it may influence the subsequent surgical treatment. We report two surgical cases of interstitial pneumonia that occurred during BEP (bleomycin+etoposide+cisplatin) therapy for a primary mediastinal malignant germ cell tumor. Case 1 was a 19-year-old man and case 2 was a 24-year-old man. They both had an anterior mediastinal tumor of around 10 cm in diameter that was diagnosed as a yolk sac tumor by needle biopsy, and received BEP therapy. Interstitial pneumonia occurred at total bleomycin doses of 360 and 330 mg, respectively. They received steroid pulse treatment 103 and 109 days after starting therapy, respectively. Thereafter, they received steroid maintenance treatment by oral administration. Because they showed the improvement of interstitial pneumonia on imaging examinations, they received residual tumor resection and partial resection of the lung 17 and 26 days after starting steroid pulse treatment, respectively. Both post-operative courses were good, without the onset of respiratory failure.</p>

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