Mediastinal endodermal sinus tumour: surgical role in chemotherapy resistant cases

We report two cases of aggressive mediastinal endodermal sinus tumours (EST ) detected incidentally on a chest radiograph. The patients were being inve stigated far minor chest complaints. After three courses of cisplatin-based chemotherapy the tumour marker levels declined. However, the tumour size c ontinued to increase. Complete surgical removal was possible in one case an d significant reduction in tumour mass was achieved in the other. Reduction in the viable, tumour tissue load made the residual tumour sensitive to po stoperative chemotherapy, It is important to be aware of endodermal sinus t umours refractory to chemotherapy which may require early surgical interven tion.