GYNECOMASTIA CAUSED BY A PRIMARY MEDIASTINAL SEMINOMA

The case of a young man aged 26 is reported. He presented with a short history of painful gynaecomastia, and no other associated symptoms. R adiological investigations showed a mass in the anterior mediastinum. Endocrine investigations showed high circulating oestradiol and high h CG-beta levels. There was no evidence of primary testicular tumour or metastases. Surgical removal of the mediastinal mass led to normalizat ion of oestradiol and hCG-beta levels and regression of gynaecomastia. Histology showed the tumour to be a primary mediastinal seminoma stai ning positively for hCG-beta. Further treatment consisted of chemother apy with etoposide and cis-platinum. The patient has remained well wit h no evidence of disease recurrence. The tumour markers remain normal.