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Germ-Cell Cancer of the Testis and Related Neoplasms
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Primary mediastinal germ-cell tumors are rare. Mediastinal seminomas do not confer a worse prognosis; however, these make up the minority of mediastinal primaries. Clinically, mediastinal NSGCT behave differently compared with other primary sites; they are often less chemosensitive and associated with poorer prognosis. Mediastinal tumors of seminomatous histology have a long-term chance of cure of approximately 90%, whereas only 45% of patients with mediastinal non-seminomas are alive at 5 years.136 As a non-seminoma mediastinal primary is a poor prognostic feature it should be treated urgently with chemotherapy in the first instance. Following chemotherapy cardiothoracic surgery is often required to remove the residual masses. Viable tumor cells in the mediastinal specimen post-chemotherapy are often predictive for poor outcomes with a hazard ratio of 15 compared to necrosis alone.137
Primary Mediastinal Germ Cell Tumors (PMGCT): A Real-world Analysis From A Tertiary Cancer Care Center in India
Published in Cancer Investigation, 2023
Aparna Sharma, Rohit Reddy, Raja Pramanik, Ranjit Kumar Sahoo, Seema Kaushal, K.P. Haresh, Sunil Kumar, Lalit Kumar, Atul Sharma, Atul Batra
Patients with primary extra gonadal germ cell tumors (EGGCT), a less commonly encountered subset of germ cell tumors, present with a mediastinal tumor in the absence of a gonadal primary (1). EGGCT is an uncommon entity and constitutes only around 1–5% of all germ cell tumors (2). Patients with EGGCT present as midline tumors extending variably from the pineal gland to the coccyx; the most common primary site being anterior mediastinum (50–70%) followed by retroperitoneum (30–40%) (3) and intracranial locations. Moreover, extragonadal GCTs are frequent in young children (sacrococcyx location). Furthermore, primary mediastinal germ cell tumors (PMGCT) constitute 12–16% of all mediastinal malignancies (4). They are broadly classified into two subtypes: seminomatous germ cell tumor, and nonseminomatous germ cell tumor (NSGCT) subtype that includes embryonal carcinoma (EC), teratomas (mature or immature), yolk sac carcinoma (YST) and choriocarcinoma and mixed histologies (2). Though EGGCT appear morphologically similar to the gonadal counterparts, they are clinically, molecularly and embryological distinct (5).