Abstract | BACKGROUND: Mediastinal germ cell tumors (GCTs) are rare and usually located in anterior mediastinum. We aimed to review clinical and pathological characteristics of these tumors. PROCEDURE: Between 1973 and 2011, 24 children with mediastinal GCTs were diagnosed. Hospital files were reviewed for presenting complaints, clinical, radiological and other laboratory data, surgical practices, treatments, and outcomes. RESULTS: Median age was 4.5 years (0.2-16) (male/female: 10/14). Most common initial complaints were dyspnea, cough, anorexia/ fatigue, fever, and chest pain. Primary tumors were located in anterior mediastinum (n = 22), posterior mediastinum (n = 1), and sternum (n = 1). Thirteen of 24 cases had mature teratomas (54.2%); four (16.7%) endodermal sinus tumor (EST); four (16.7%) immature teratomas; and one (4.2%) each of embryonal carcinoma, teratocarcinoma, and malignant teratoma. Mature teratomas underwent only surgical resection and were under follow-up without disease. Four cases with ESTs received chemotherapy and radiotherapy (n = 3), three underwent surgical resections: three died, one was followed for 284 months in remission. All but one immature teratomas were treated with surgery and all were under follow-up without disease. Two patients with embryonal carcinoma and malignant teratoma didn't undergo surgery; both received chemotherapy and radiotherapy but died with disease. The patient with teratocarcinoma was treated with surgery and chemotherapy but died with disease. CONCLUSIONS: No adjuvant therapy is needed for mature teratomas. Immature teratomas must be under close follow-up for recurrences. Prognosis for mediastinal malignant GCTs was poor. These cases need intensive chemotherapies and effective local control measures as surgery -/+ radiotherapy to ensure long-term survival.
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Authors | Bilgehan Yalçın, Hacı Ahmet Demir, Feridun Cahit Tanyel, Zühal Akçören, Ali Varan, Canan Akyüz, Tezer Kutluk, Münevver Büyükpamukçu |
Journal | Pediatric hematology and oncology
(Pediatr Hematol Oncol)
Vol. 29
Issue 7
Pg. 633-42
(Oct 2012)
ISSN: 1521-0669 [Electronic] England |
PMID | 22877235
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Child
- Child, Preschool
- Female
- Follow-Up Studies
- Humans
- Infant
- Male
- Mediastinal Neoplasms
(diagnosis, therapy)
- Neoplasms, Germ Cell and Embryonal
(diagnosis, therapy)
- Prognosis
- Remission Induction
- Retrospective Studies
- Treatment Outcome
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