Management of primary mediastinal seminoma.

Radiation therapy has been the usual initial treatment for mediastinal seminoma in the past. However, 25 to 40 percent of patients are not cured by this therapy, and other therapy is needed. Review of case reports show that vinblastine, bleomycin, and cis-platinum are effective therapy for metastatic disease, advanced disease within the chest, or mixed germ cell tumors with nonseminomatous elements. The use of tumor markers and chemotherapy must be integrated into the staging of and therapy for primary mediastinal seminoma.