A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade

Mahmoud Beheshti Monfared; Hamid Ghaderi; Zahra Ansari Aval; Manouchehr Hekmat; Seyedeh Adeleh Mirjafari; Reza Beheshti Monfared

doi:10.34172/jnp.2022.17219

doi: 10.34172/jnp.2022.17219

Abstract View: 1098

Case Report

A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade

Mahmoud Beheshti Monfared ¹ , Hamid Ghaderi ¹ , Zahra Ansari Aval ²^* , Manouchehr Hekmat ¹ , Seyedeh Adeleh Mirjafari ³ , Reza Beheshti Monfared ⁴

¹ Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
² Clinical Research and Development Center, Shahid Modarres Hospital, Department of Cardiac Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
³ Department of Pediatrics, Ali-Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran
⁴ Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

*Corresponding author: Zahra Ansari Aval, Email: Z.ansari@sbmu.ac.ir, zahraansariaval@gmail.com

Abstract

The clinical manifestations of extragonadal germ cell tumor (EGGCT) depend on its location and are often caused by compression on surrounding structures. Pericardial effusion is absolutely rare as an initial clinical manifestation for this tumor. We report a 31-year-old man presenting to the emergency department with dyspnea. Two-dimensional echocardiography revealed a massive pericardial effusion with impending tamponade. The patient was immediately transferred to the operating room where a cardiac surgeon drained bloody effusion. A mediastinal mass measuring 173×105×105 mm was accidentally noticed during COVID-19 work-up. Fine core needle biopsy of the mass led to the diagnosis of a germ cell tumor, which was treated appropriately. This study shows the importance of proper work-up in pericardial effusion cases with chest CT-scan as an important part of it.

Keywords: Extragonadal germ cell tumor, Massive pericardial effusion, Tamponade, Cardiac surgery

Implication for health policy/practice/research/medical education:

The patient had massive pericardial effusion. A mediastinal mass measuring 173×105×105 mm was accidentally noticed, which led to the diagnosis of a germ cell tumor. This study shows the importance of proper work-up in pericardial effusion cases with chest CT-scan as an important part of it.

Please cite this paper as: Beheshti Monfared M, Ghaderi H, Ansari Aval Z, Hekmat M, Mirjafari SA, Beheshti Monfared R. A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade. J Nephropathol. 2022;11(x):exx. DOI: 10.34172/ jnp.2022.xx.

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