Female, 68 years old, Primary mediastinal giant cell tumor
A mediastinal giant cell tumor is a rare, aggressive benign tumor that usually develops near a joint at the end of a bone. Most occur in the long bones of the legs and arms in young adults when skeletal bone growth is complete. Giant cell tumors have a high recurrence rate and a potential for aggressive behavior. The metastatic forms of giant cell tumors are known as malignant sarcomas.
In January 2022, the patient was in a weakened condition with symptoms including dry throat, cough, fatigue, shortness of breath, and hard lumps on her chest. Based on the CT Scan of the chest with contrast, the results showed a cystic mixed solid anterior mediastinal mass, multiseptated with a calcified component, especially in the septations. There was an increase in solid components and septa, raising concern for malignant thymic carcinoma.
The mass measured about 9x11x11 cm, extending to the left and protruding exophytically anteriorly to reach the anterior thorax wall. It caused destruction of the left anterior 1 and 2 ribs and invaded the intercostal muscles adjacent to the mass. Additionally, it pushed the right and left pectoralis anteriorly and attached to the left supranterior pericardium with minimal pleural effusion. Due to the size and location, treatment for Mediastinal Cancer like surgery is not advisable till the tumor reach a smaller size. The patient then underwent radiotherapy for 30 sessions hoping to shrink the size and continue with ECCT post-radiotherapy.
Her Treatment History:
- 15th session: CT scan showed progressive tumors.
- 20th session: Radiotherapy was stopped due to the tumor's increased size and lack of response to treatment.
- Started ECCT post-radiotherapy.
After using ECCT for 9 months, the CT Scan results showed a decrease in the size of the tumor mass from 9x11x11 cm to 8.1x8.2x8 cm compared to the previous scan. The patient's current condition has significantly improved, with reduced complaints of coughing and fatigue, improved breathing, and visibly smaller lump.
Throughout her journey, there was no inflammation occurring in the tumor area, and neither chemotherapy nor surgery were performed pre and post radiotherapy. The patient's key to success was her strong will and high discipline in following the given schedule, ensuring she had enough nutrition for her body to excrete the dead cells over time. Additionally, her thorax functions showed no abnormalities.