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Multi-Faceted Case Study: Subvalvular Aortic Stenosis and Germ Cell Tumor in a 37-Year-Old Man

Explore a complex medical case of a 37-year-old man with a history of subaortic valve resection, cervical adenopathy, salivary gland adenocarcinoma, testicular germ cell tumor, and cardiac issues including severe subvalvular aortic stenosis. Surgical and pathological details are highlighted alongside research on tumor necrosis factor and calcium deposition.

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Multi-Faceted Case Study: Subvalvular Aortic Stenosis and Germ Cell Tumor in a 37-Year-Old Man

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  1. Subvalvular AS&Germ cell tumor

  2. 37 yrs old man • Hx of subaortic valve resection, 28 yrs ago

  3. Hx of left cervical adenopathy, 2 yrs ago Excisional biopsy Adenocarcioma of salivary gland (malignant mixed tumor)

  4. Abdominal para-aortic lymphadenopathy

  5. Hx left testicular Germ cell tumor, 20 months ago Left radical orchidectomy Malignant mixed germ cell tumor

  6. Palpitation & DoE Fc III Echo: Sever Subvalvular AS Moderate Valvular AS Moderate to sever AI Mild LV enlargement Aortic root = 50mm-AVannulus=30mm LVEF=50% Normal RV + Normal RV EF Normal PAP

  7. TEE: • Previous data & long mobile mass on junction of SVC & RA ( 20  6 mm)

  8. No changes of mass was seen upon anticoagulant therapy

  9. Surgery: • Subaortic valve ring resection & AVR (STM:25)

  10. Pathology of mobile mass: • Organized thrombus & focal calcification

  11. Multiple reports were seen about association between and other cancer and aortic stenosis

  12. Studies suggest that tumor necrosis factor (TNF) lead to calcium deposition on aortic valve & subvalvular arrea

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