Gallium-67 citrate scanning in primary mediastinal seminoma.

A 24-year-old white male who had enjoyed excellent health in the past was admitted to the hospital complainingof intermittent sharp pains, of 3 wk duration, in the upper retrosternal and in terseapular areas. There was no history of cough, dyspnea, he moptysis,fever,weight loss,or previoushospitalizations.Physical examinationwasentirely withinnormal limits;in particular, there was no lymphadenopathy, the lungs were clear to percussionand ausculation, and no abnormalities were present in the testicles. Urinalysis,CBC, and liverenzymeswere normal. Determinations of alpha-fete-proteinand humanchorionicgonadotropinwere negative.Chest radiograph (Fig. 1) showeda large, slightly lob ulated, anterior mediastinal mass with no calcifications. On to mography the mass appeared to be primarily in the right para tracheal and hilar region.A Ga-67 citrate tomographicscan (Fig. 2) showed a large abnormal accumulation of the tracer in the mediastinum corresponding to the mass seen in the radiographs. No otherabnormalaccumulationsof tracerwereseen. Open thoracotomy revealed a 15-cm, multinodular, nonen capsulated mass in the anterior mediastinum. Microscopic cx