Estenosis pulmonar supravalvular como manifestación de un tumor mediastinal de células germinales: reporte de caso

Mario B. García-Saavedra; Hilton D’janggo-Cruz; Jianmartín A. Galecio; Cristian A. Chava-Ponte; Brigitte Illary Pizarro-Alvarado; Guillermo Valencia; Patricia Rioja-Viera; Ángel Zamora-Chuquisengo

doi:10.47487/apcyccv.v7i2.569

Authors

Mario B. García-Saavedra Centro Médico Naval «Cirujano Mayor Santiago Távara», Lima, Perú. https://orcid.org/0000-0002-3534-5119
Hilton D’janggo-Cruz Centro Médico Naval «Cirujano Mayor Santiago Távara», Lima, Perú. https://orcid.org/0009-0000-9472-8008
Jianmartín A. Galecio Hospital de Apoyo II-2 Sullana, Piura, Perú / Estrategia de Prevención y Control de Cáncer de la DIRESA, Piura, Perú. https://orcid.org/0009-0004-8344-5984
Cristian A. Chava-Ponte Centro Médico Naval «Cirujano Mayor Santiago Távara», Lima, Perú. https://orcid.org/0000-0001-5623-0567
Brigitte Illary Pizarro-Alvarado Centro Médico Naval «Cirujano Mayor Santiago Távara», Lima, Perú. https://orcid.org/0009-0002-1010-317X
Guillermo Valencia Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú. https://orcid.org/0000-0002-4234-4448
Patricia Rioja-Viera Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú. https://orcid.org/0000-0003-3141-7418
Ángel Zamora-Chuquisengo Centro Médico Naval «Cirujano Mayor Santiago Távara», Lima, Perú. https://orcid.org/0000-0002-3765-1275

DOI:

https://doi.org/10.47487/apcyccv.v7i2.569

Keywords:

Stenosis Pulmonary Artery, Neoplasms, Germ Cell and Embryonal, Seminoma, Multimodal Imaging

Abstract

Extrinsic compression of the pulmonary artery by a mediastinal mass is an exceedingly rare cause of pulmonary stenosis. We report the case of a 22-year-old man with no relevant medical history who, during a pre-surgical evaluation, presented with a three-month history of exertional dyspnoea. Echocardiography demonstrated supravalvular pulmonary stenosis, and chest computed tomography revealed a giant mediastinal mass encasing the great vessels and causing collapse of the left pulmonary artery branch. Mediastinal biopsy and immunohistochemical analysis were consistent with a primary mediastinal germ cell tumour of seminomatous morphology, accompanied by serum alpha-fetoprotein elevation, leading to its classification as a high-risk extragonadal germ cell tumour. This case highlights the importance of multimodal imaging in the differential diagnosis of mediastinal masses with compressive cardiac involvement, as well as the value of histopathological correlation and tumour marker assessment in guiding prognosis and multidisciplinary management.

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