生殖细胞源性肿瘤大多原发于卵巢或睾丸,发生于生殖腺外者少见。我科最近尸检一例原发于纵隔的混合性生殖细胞癌(胚胎性癌伴绒毛膜癌成分),且有多数脏器广泛转移,较为罕见,报告如下: 患者男,56岁。消瘦、纳差伴胸闷气急半年,近三个月病情加重,两乳房胀痛,无咳嗽、血痰,无发热、盗汗。检查两乳房饱满、压痛,乳头、乳晕略见色素加深。两肺未闻啰音,腹软,无其它异常。当地及本院门诊胸片示纵隔增宽,并见块影,拟诊纵隔恶性淋巴瘤,84年4月4日入院。经局部放射及化学药物综合治疗,疗效不显,并发现右颈淋巴结肿大如指头,活检报告:淋巴结转移性低分化腺癌(来源难定)。多次AFP检查阴性,HCG-β亚单位测定均>500ng/ml,最高780ng/ml,曾怀疑睾丸隐灶性肿瘤而未证实,因病情日益加重,于同年7月12日恶病质全身衰竭死亡。 尸检所见:两侧乳腺除乳头、乳晕处有色素沉着 Germ cell-derived tumors are mostly found in the ovaries or testes, and are rare outside the gonads. Our department recently autopsy a case of mixed germ cell cancer (immortal carcinoma with choriocarcinoma components) in the mediastinum, and most of the organs are widely metastasized, and it is rare. The report is as follows: The patient male is 56 years old. Loss of weight, anorexia with chest tightness and shortness of breath six months, the condition worsened in the last three months, two breast pain, no cough, blood stasis, no fever, night sweats. Check the two full breasts, tenderness, nipples, areola pigment slightly deepened. The lungs did not hear rales, but the abdomen was soft and there were no other abnormalities. Local and outpatient chest radiographs showed widened mediastinum, and a block shadow was seen. The patient was diagnosed with mediastinal malignant lymphoma. He was admitted to hospital on April 4th, 84. After comprehensive treatment with local radiation and chemical drugs, the curative effect was not significant. Right neck lymph nodes were found to be swollen as fingertips. Biopsy report: lymphatic metastatic poorly differentiated adenocarcinoma (difficult source). Multiple AFP tests were negative, HCG-β subunits were all measured> 500ng/ml, the highest 780ng/ml, had suspected that the testicular cryptocarcinoma but not confirmed, due to the growing condition, in the same year on July 12 died of cachexia systemic failure. Autopsy findings: pigmentation on both sides of the mammary glands except the nipples and areola