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Background <p>Mediastinal seminoma is a very rare extragonadal malignant germ cell tumor that is often misdiagnosed.</p> Case presentation <p>A 27-year-old male presented with dyspnea. Imaging demonstrated a mass invading the right upper lobe, extending to the anterior mediastinum, and invading the superior vena cava (SVC). Computed tomography (CT)-guided biopsy showed necrotizing granulomas, and empiric antituberculosis therapy was initiated. The absence of clinical and radiological improvement after four months necessitated diagnostic re-evaluation via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA biopsies from the mass invading the SVC through an intravascular approach were performed without significant adverse events and yielded adequate tissue. Rapid on-site assessment and histopathology confirmed seminoma. Following diagnosis, the patient received chemotherapy with subsequent clinical and radiological improvement during follow-up.</p> Conclusions <p>Intravascular EBUS-TBNA is a safe, minimally invasive technique for diagnosing primary mediastinal Seminoma invading the SVC.</p>

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Intravascular EBUS-TBNA for diagnosis of primary mediastinal seminoma invading the superior vena cava: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Esraa Hamza,
  • Wael Emam,
  • Fatma Hafez,
  • Nehad Osman,
  • Ashraf Madkour

摘要

Background

Mediastinal seminoma is a very rare extragonadal malignant germ cell tumor that is often misdiagnosed.

Case presentation

A 27-year-old male presented with dyspnea. Imaging demonstrated a mass invading the right upper lobe, extending to the anterior mediastinum, and invading the superior vena cava (SVC). Computed tomography (CT)-guided biopsy showed necrotizing granulomas, and empiric antituberculosis therapy was initiated. The absence of clinical and radiological improvement after four months necessitated diagnostic re-evaluation via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA biopsies from the mass invading the SVC through an intravascular approach were performed without significant adverse events and yielded adequate tissue. Rapid on-site assessment and histopathology confirmed seminoma. Following diagnosis, the patient received chemotherapy with subsequent clinical and radiological improvement during follow-up.

Conclusions

Intravascular EBUS-TBNA is a safe, minimally invasive technique for diagnosing primary mediastinal Seminoma invading the SVC.