A 28-year-old male visited our hospital with complaint of chest pain. Clinical examination revealed a huge mediastinal mass which was diagnosed as non-seminomatous germ cell tumor. The patient underwent 5 cycles of chemotherapy (bleomycin, etoposide, and cisplatin) followed by resection of the tumor combined with left upper lobectomy. Final pathological diagnosis was germ cell tumor with somatic-type malignancy. While the prognosis of mediastinal germ cell tumor with somatic-type malignancy is known to be extremely poor, multimodality at an early stage is the key to successful treatment.
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