The diagnostic and prognostic value of tumor markers in giant mediastinal endodermal sinus tumor with prolonged survival: Twelve-year follow up after radical resection

We report a case of 16 -year male who presented with nonproductive cough, chest pain, and hemoptysis. His chest -x-ray and computerized tomographic scan (CT) of the thorax with contrast enhancement revealed a large mediastinal mass mostly occupying the left hemithorax. Percutaneous CT scan-guided biopsy of the mediastinal mass was reported as an endodermal sinus tumor (EDST). Serum alpha-fetoprotein levels were markedly raised (120,000 ng/ml). After completion of chemotherapy repeat, CT scan of the thorax revealed a large residual mass. Radical resection of the tumor was carried out. Twelve-year post-surgical resection follow-up with serial serum alpha-fetoprotein (AFP) tumor marker levels and CT scan of the thorax showed no recurrence. •A 16-years old male presented with history of cough, shortness of breath, chest pain and scanty hemoptysis.•Serum alpha-fetoprotein levels were markedly high 120,000 ng/ml.•Chemotherapy was given.•Radical surgical resection was carried out.•Alpha feto protein levels were serial determined over the past twelve year, which stayed within normal range. This tumor marker has high diagnostic and prognostic value for follow up in such tumors.•Follow CT scan of thorax showed no recurrence.