Cystic Seminoma With Elevated Value of Carbohydrate Antigen 19-9 in Tumor Fluid Mimicking Cystic Teratoma Cheng-Ken Tsai, MD, Tsai-Wang Huang, MD, Chun-Chang.

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Cystic Seminoma With Elevated Value of Carbohydrate Antigen 19-9 in Tumor Fluid Mimicking Cystic Teratoma Cheng-Ken Tsai, MD, Tsai-Wang Huang, MD, Chun-Chang Li, MD, Chih-Ming Hsieh, MD, Shih-Chin Lee, MD, Yeung-Leung Cheng, MD, PhD, Herng-Sheng Lee, MD The Annals of Thoracic Surgery Volume 88, Issue 5, Pages 1693-1695 (November 2009) DOI: 10.1016/j.athoracsur.2009.04.026 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) A bulging opacity (4.7 cm, arrow) with calcified rim shadow projected of right paramedian anterior mediastinum. (B) Lateral view of the chest roentgenogram showed one large tumor in the anterior mediastinum. The Annals of Thoracic Surgery 2009 88, 1693-1695DOI: (10.1016/j.athoracsur.2009.04.026) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 A computed tomographic scan of the mediastinum show unilocular cystic structure (approximately 4.9 × 3.7 cm in size) with low attenuation signal within the cyst, which suggests fluid content. The lesion is sharply demarcated from the surrounding soft tissue with multifocal calcifications in the wall. The Annals of Thoracic Surgery 2009 88, 1693-1695DOI: (10.1016/j.athoracsur.2009.04.026) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The resected surgical specimen showed cut surface of the bilobed loculated cyst with two excrescences attached to the wall of the cyst (mural nodules) and containing yellow-brown cystic fluid. The Annals of Thoracic Surgery 2009 88, 1693-1695DOI: (10.1016/j.athoracsur.2009.04.026) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Higher magnification of seminomatous component showing large polygonal cells with clear cytoplasm, round nuclei, and prominent nucleoli (Hematoxylin & eosin stain, ×400). (B) Immunohistochemical stain for placental alkaline phosphatase showing cytoplasmic positivity in the tumor cells (arrow). (Original magnification ×400.) The Annals of Thoracic Surgery 2009 88, 1693-1695DOI: (10.1016/j.athoracsur.2009.04.026) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions