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1. Takeda S, Miyoshi S, Ohta M, Minami M, Masaoka A, Matsuda H: Primary germ cell tumors in the mediastinum: a 50-year experience at a single Japanese institution. Cancer; 2003 Jan 15;97(2):367-76

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary germ cell tumors in the mediastinum: a 50-year experience at a single Japanese institution.
  • BACKGROUND: Primary germ cell tumors (GCT) of the mediastinum share similar clinical and biologic characteristics, which are different from their testicular counterpart.
  • The purpose of the current study was to review the authors' institutional experience of mediastinal GCT, emphasizing the clinical spectrum, time trends of treatment, and recent advances in therapeutic modalities for malignant GCT.
  • METHODS: Between 1951 and 2000, 129 patients (70 males and 59 females) underwent surgical treatment for GCT, which accounted for 16.0% of the mediastinal tumors during the same period.
  • All patients with mature teratoma were cured by resection alone.
  • Eight of the 13 patients (61.5%) with seminoma were symptomatic and 10 of 13 patients (83.3%) survived after surgery and radiation with/without chemotherapy.
  • After 1986, six of eight patients received cisplatin-based chemotherapy, including three who received additional high-dose chemotherapy with a supporting peripheral blood stem cell transplantation until tumor markers normalized.
  • CONCLUSIONS: The institutional experience indicates the benign nature of mediastinal mature teratomas and the excellent prognosis for patients with seminomas after resection.
  • An improved survival advantage was ensured with cisplatin-based preoperative chemotherapy in patients with NSGCT.
  • [MeSH-major] Mediastinal Neoplasms. Neoplasms, Germ Cell and Embryonal
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Infant. Japan. Male. Middle Aged. Seminoma / diagnosis. Seminoma / epidemiology. Seminoma / therapy. Survival Analysis. Teratoma / diagnosis. Teratoma / epidemiology. Teratoma / therapy

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  • [Copyright] Copyright 2003 American Cancer Society
  • (PMID = 12518361.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Chen PY, Chen WY, Ho DM, Pan CC: Malignant ganglioneuroma arising from mediastinal mixed germ cell tumor. J Chin Med Assoc; 2007 Feb;70(2):76-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant ganglioneuroma arising from mediastinal mixed germ cell tumor.
  • Mixed germ cell tumors with non-germ cell malignant components rarely occur in the anterior mediastinum.
  • We report a case of a 34-year-old man who presented with an anterior mediastinum mass.
  • The patient received preoperative chemotherapy and subsequent complete resection of the residual tumor.
  • Pathologic examination of the excised specimen showed predominantly malignant ganglioneuroma and small residual foci of teratoma.
  • To our knowledge, this is the first reported case of a malignant ganglioneuroma arising from mediastinal mixed germ cell tumor.
  • [MeSH-major] Ganglioneuroma / etiology. Mediastinal Neoplasms / complications. Neoplasms, Germ Cell and Embryonal / complications

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  • (PMID = 17339149.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
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3. Nakamura Y, Matsumura A, Katsura H, Sakaguchi M, Ito N, Kitahara N, Ose N, Kitaichi M: Cisplatin-based chemotherapy followed by surgery for malignant nonseminomatous germ cell tumor of mediastinum: one institution's experience. Gen Thorac Cardiovasc Surg; 2009 Jul;57(7):363-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cisplatin-based chemotherapy followed by surgery for malignant nonseminomatous germ cell tumor of mediastinum: one institution's experience.
  • OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of cisplatin-based chemotherapy followed by surgery for patients with a malignant nonseminomatous germ cell tumor (NSGCT) of the mediastinum.
  • METHODS: Ten patients with malignant NSGCTs received cisplatin-based induction chemotherapy and then underwent surgery.
  • RESULTS: A partial response to induction chemotherapy was noted in eight patients and no response in two.
  • The induction chemotherapy was tolerated well by all the patients.
  • Each patient underwent complete surgical resection of the residual tumor following chemotherapy.
  • A yolk sac tumor was detected in one patient and malignant teratoma along with a yolk sac tumor in one patient postoperatively.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mediastinal Neoplasms / drug therapy. Neoadjuvant Therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Bleomycin / administration & dosage. Bleomycin / therapeutic use. Cisplatin / administration & dosage. Cisplatin / therapeutic use. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / therapeutic use. Humans. Male. Neoplasm, Residual. Prognosis. Survival Analysis

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  • [Cites] J Clin Oncol. 2001 Feb 1;19(3):682-8 [11157018.001]
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  • [Cites] Cancer. 2003 Jan 15;97(2):367-76 [12518361.001]
  • (PMID = 19597926.001).
  • [ISSN] 1863-6705
  • [Journal-full-title] General thoracic and cardiovascular surgery
  • [ISO-abbreviation] Gen Thorac Cardiovasc Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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4. Priola AM, Priola SM, Cardinale L, Cataldi A, Fava C: The anterior mediastinum: diseases. Radiol Med; 2006 Apr;111(3):312-42
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  • [Title] The anterior mediastinum: diseases.
  • Mediastinal tumours are frequently asymptomatic and first noted on routine chest radiograph.
  • In most cases, evaluation should proceed to spiral computed tomography (sCT) of the chest with iodinated contrast material.
  • The specific location and appearance of tumours on sCT is instrumental in planning further diagnostic and treatment strategies.
  • Primary tumours in the anterior mediastinum account for half of all mediastinal masses.
  • They comprise various benign and malignant neoplasms, but a wide variety of nonneoplastic lesions (developmental, inflammatory) can present as a localised mass in this compartment.
  • The most common primary anterior mediastinal tumours are thymoma, teratoma and lymphoma; all other lesions are rare.
  • Understanding the pathology, clinical presentation, imaging and diagnosis of the major tumour types is instrumental in the safe and efficient work-up of a mediastinal mass.
  • Patients with primary mediastinal masses and cysts will usually undergo surgical resection; radiological and clinical features should prompt limited biopsy specimens followed by oncologic consultation, and chemotherapy or radiotherapy when appropriate.
  • The objective of this review was to examine the role of diagnostic imaging in the management of masses of the anterior mediastinum.
  • [MeSH-major] Diagnostic Imaging. Mediastinal Diseases / diagnosis. Mediastinal Neoplasms / diagnosis
  • [MeSH-minor] Contrast Media. Diagnosis, Differential. Humans. Lymphatic Diseases / diagnosis. Mediastinal Cyst / diagnosis. Mediastinitis / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Thymus Gland / pathology. Tomography, Spiral Computed

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  • (PMID = 16683081.001).
  • [ISSN] 0033-8362
  • [Journal-full-title] La Radiologia medica
  • [ISO-abbreviation] Radiol Med
  • [Language] eng; ita
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Contrast Media
  • [Number-of-references] 78
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5. Iyoda A, Hiroshima K, Yusa T, Toyozaki T, Fujisawa T, Ohwada H: The primary mediastinal growing teratoma syndrome. Anticancer Res; 2000 Sep-Oct;20(5C):3723-6
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  • [Title] The primary mediastinal growing teratoma syndrome.
  • We encountered a case of mediastinal immature teratoma which revealed the feature of the so-called growing teratoma syndrome.
  • A 20-year-old male with a cough was discovered to have an abnormal shadow in the mediastinum.
  • The specimen with percutaneous needle biopsy revealed mature teratoma.
  • The tumor was suspected to be mature teratoma with a malignant component because of the high level of serum AFP and he underwent chemotherapy.
  • The resected tumor was diagnosed as immature teratoma, although most of the tumor tissue was mature component.
  • [MeSH-major] Mediastinal Neoplasms / diagnosis. Teratoma / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy, Needle. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Cough. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Humans. Magnetic Resonance Imaging. Male. Radiography, Thoracic. Syndrome. Treatment Outcome. alpha-Fetoproteins / analysis

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  • (PMID = 11268445.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / alpha-Fetoproteins; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 5
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6. Calaminus G, Schneider DT, Weissbach L, Schönberger S, Okpanyi V, Leuschner I, Poremba C, Göbel U: Survival after an antiangiogenetic therapy and surgery in a wide spread growing teratoma originating from a testicular mixed malignant germ cell tumor. Klin Padiatr; 2009 May-Jun;221(3):136-40
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  • [Title] Survival after an antiangiogenetic therapy and surgery in a wide spread growing teratoma originating from a testicular mixed malignant germ cell tumor.
  • Growing teratoma is still an often unsolved problem especially in male with mixed malignant GCTs of the testis or the mediastinum.
  • This specific situation with progressive tumor growth and simultaneous normalization of tumor markers during or after treatment of malignant GCTs with teratomatous elements is judged as a fatal situation if this situation can not be controlled by extensive surgery, as teratoma are not sensible to chemotherapy or irradiation.
  • Here, we report the case history of a 17-year old male patient with a testicular malignant GCT and wide spread lymph node metastases, who developed a rapidly progressive growing teratoma within the lymph node metastases.
  • Within the molecular profile of the tumor we could find a cytogenetic picture typically found in malignant adult GCTs.
  • However, following an individual treatment attempt, this patient was treated with a four-agent combination of drugs with antiangiogenetic potential as well as low-dose cyclic chemotherapy.
  • We therefore would like to highlight this treatment approach in unresectable growing teratoma and would like to stimulate further research and collaboration to come to an optimized treatment suggestion for this group of poor prognostic patients.
  • [MeSH-major] Angiogenesis Inhibitors / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endodermal Sinus Tumor / drug therapy. Endodermal Sinus Tumor / surgery. Lymph Node Excision. Lymphatic Metastasis. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / surgery. Teratoma / drug therapy. Teratoma / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal / adverse effects. Antibodies, Monoclonal, Humanized. Bevacizumab. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Follow-Up Studies. Humans. Interferon-alpha / administration & dosage. Interferon-alpha / adverse effects. Lymph Nodes / blood supply. Lymph Nodes / pathology. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Recombinant Proteins. Reoperation. Salvage Therapy. Survival Rate. Thalidomide / administration & dosage. Thalidomide / adverse effects. Tomography, X-Ray Computed. Vinblastine / administration & dosage. Vinblastine / adverse effects

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  • [CommentIn] Klin Padiatr. 2009 May-Jun;221(3):134-5 [19437359.001]
  • (PMID = 19437360.001).
  • [ISSN] 1439-3824
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Interferon-alpha; 0 / Recombinant Proteins; 2S9ZZM9Q9V / Bevacizumab; 4Z8R6ORS6L / Thalidomide; 5V9KLZ54CY / Vinblastine; 76543-88-9 / interferon alfa-2a
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7. Yano M, Fujii Y: [Results of surgical treatment for pimary germcell tumors of the mediastinum]. Nihon Geka Gakkai Zasshi; 2006 Nov;107(6):278-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Results of surgical treatment for pimary germcell tumors of the mediastinum].
  • Primary germ cell tumors of the mediastinum are relatively rare with complicated backgrounds including various pathology with mixed types and characteristics.
  • The primary treatment for mature teratoma is surgical resection.
  • In elderly patients, mature teratomas possibly involve epithelial malignant transformation.
  • Cisplatin-based chemotherapy plays an important role in the treatment of both seminoma and nonseminoma.
  • Cases with pleural dissemination or metastasis also have a worse prognosis, with a median survival time of 5 months.
  • The reasons for the poor prognosis in nonseminoma are the inclusion of patients in whom chemotherapy is not effective and those with advanced disease with metastasis.
  • It would be possible to improve the prognosis with the establishment of a standard treatment regimen, development of new agents for the treatment of tumors resistant to current chemotherapy regimens, and detection of more tumors in the early stage.
  • [MeSH-major] Mediastinal Neoplasms / surgery. Neoplasms, Germ Cell and Embryonal / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Child. Child, Preschool. Cisplatin / therapeutic use. Female. Humans. Infant. Japan. Male. Middle Aged. Prognosis. Survival Rate. Time Factors

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  • (PMID = 17147287.001).
  • [ISSN] 0301-4894
  • [Journal-full-title] Nihon Geka Gakkai zasshi
  • [ISO-abbreviation] Nihon Geka Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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8. Athanasiou A, Vanel D, El Mesbahi O, Theodore C, Fizazi K: Non-germ cell tumours arising in germ cell tumours (teratoma with malignant transformation) in men: CT and MR findings. Eur J Radiol; 2009 Feb;69(2):230-5
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  • [Title] Non-germ cell tumours arising in germ cell tumours (teratoma with malignant transformation) in men: CT and MR findings.
  • PURPOSE: To describe the imaging findings of germ cell tumours (GCT) containing non-germ cell malignant components (also designated teratoma with malignant transformation or TMT).
  • All patients had computed tomography (CT) and/or magnetic resonance (MR) studies before and after initial surgery and chemotherapy, as well as during follow-up.
  • Imaging findings were correlated with the response to treatment and with overall survival.
  • Other histological types of malignant transformation included adenocarcinoma (n=3) and bronchoalveolar carcinoma (n=1).
  • Overall, 9 patients relapsed at a median time of 84 months (range 60-168).
  • RESULTS: Non-GCT malignant transformation was identified in the retroperitoneum (5), testis (3), mediastinum (3), peritoneum (2) and lungs (1).
  • The CT and MR imaging findings before treatment and after relapse were evaluated with emphasis on imaging features that could possibly imply the presence of malignant transformation (heterogeneously enhancing soft-tissue masses, ossified masses with calcified lymph nodes, diffuse epiploic thickening associated with ascites and peritoneal nodules, pulmonary alveolar infiltration with septal thickening).
  • Imaging can be useful as CT and MR findings may suggest this entity and lead to an early biopsy and appropriate treatment.
  • [MeSH-major] Cell Transformation, Neoplastic / pathology. Magnetic Resonance Imaging. Teratoma / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 19056194.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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9. Vuky J, Bains M, Bacik J, Higgins G, Bajorin DF, Mazumdar M, Bosl GJ, Motzer RJ: Role of postchemotherapy adjunctive surgery in the management of patients with nonseminoma arising from the mediastinum. J Clin Oncol; 2001 Feb 01;19(3):682-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Role of postchemotherapy adjunctive surgery in the management of patients with nonseminoma arising from the mediastinum.
  • PURPOSE: To evaluate the role of postchemotherapy surgery in patients with nonseminomatous germ cell tumors arising from the anterior mediastinum.
  • PATIENTS AND METHODS: Thirty-two patients with nonseminoma arising from a mediastinal primary site were treated on a clinical trial at our center, and they underwent postchemotherapy surgery.
  • Histologic analysis of resected residua postchemotherapy revealed viable tumor in 66%, teratoma in 22%, and necrosis in 12% of the specimens.
  • Viable tumor included embryonal carcinoma, choriocarcinoma, yolk sac carcinoma, seminoma, and teratoma with malignant transformation to nongerm cell histology (eg, sarcoma).
  • CONCLUSION: Surgical resection of residual mass after chemotherapy plays an integral role in the management of patients with primary mediastinal nonseminoma.
  • Teratoma and viable tumor were found in the majority of resected residua after chemotherapy.
  • Because patients who undergo conventional salvage chemotherapy programs rarely achieve long-term disease-free status, selected patients with elevated markers after chemotherapy are considered candidates for surgical resection.
  • [MeSH-major] Germinoma / surgery. Mediastinal Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Chorionic Gonadotropin, beta Subunit, Human / blood. Humans. Lung Neoplasms / secondary. Male. Middle Aged. Neoadjuvant Therapy. Prognosis. Prospective Studies. Randomized Controlled Trials as Topic. Survival Rate. alpha-Fetoproteins / metabolism

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  • (PMID = 11157018.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-09207-23
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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10. Terenziani M, D'Angelo P, Bisogno G, Boldrini R, Cecchetto G, Collini P, Conte M, De Laurentis T, Ilari I, Indolfi P, Inserra A, Piva L, Siracusa F, Spreafico F, Tamaro P, Lo Curto M: Teratoma with a malignant somatic component in pediatric patients: the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) experience. Pediatr Blood Cancer; 2010 Apr;54(4):532-7
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  • [Title] Teratoma with a malignant somatic component in pediatric patients: the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) experience.
  • BACKGROUND: Teratoma with a malignant somatic component (TMSC) is rare but described in adults, whereas information on pediatric presentation is sparse.
  • PROCEDURE: The Associazione Italiana Ematologia Oncologia Pediatrica identified 14 cases of TMSC.
  • RESULTS: The series (9 female, 5 male) showed the following disease: testis (2), sacrococcygeal (3), ovary (3), retroperitoneum (3), mediastinum (2), and foot soft tissue (1).
  • Distribution of the somatic component was: carcinoma (4), pancreatic neuroendocrine tumor (1), neuroblastoma (3), rhabdomyosarcoma (3), rhabdomyosarcoma plus liposarcoma, chondrosarcoma, neurogenic sarcoma (1), chondrosarcoma plus neuroectodermal sarcoma (1), malignant peripheral nerve sheath tumor (1).
  • Chemotherapy optimized for histology should include reagents directed to the somatic malignancy, if chemosensitive.
  • Malignant GCT warrants GCT-directed chemotherapy.
  • [MeSH-major] Teratoma / pathology
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Italy. Male. Neoplasm Staging. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 20049928.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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11. Kesler KA, Einhorn LH: Multimodality treatment of germ cell tumors of the mediastinum. Thorac Surg Clin; 2009 Feb;19(1):63-9
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  • [Title] Multimodality treatment of germ cell tumors of the mediastinum.
  • Germ cell tumors originating in the anterior mediastinal compartment represent a rare but biologically interesting group of neoplasms.
  • Knowledge of the specific biologic behaviors and therapeutic strategies for the three histologic types is important.
  • PMNSGCT represent the most challenging group of malignant germ cell tumors and survival outcome is dependant on both successful chemotherapy and surgery to remove residual disease when feasible.
  • New chemotherapy strategies that reduce the incidence of persistent nonseminatous germ cell or non-germ cell cancer need continued investigation.
  • Although overall survival is inferior to nonseminomatous germ cell tumors of testicular origin, favorable subsets with pathologic evidence of either necrosis or teratoma have been identified.
  • An aggressive surgical approach after cisplatin-based chemotherapy can result in long-term survival, even in patients with persistent nonseminomatous germ cell or non-germ cell cancer, and is warranted in these otherwise young and healthy patients.
  • [MeSH-major] Mediastinal Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Biomarkers, Tumor. Diagnostic Imaging. Humans. Thoracic Surgical Procedures

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  • (PMID = 19288821.001).
  • [ISSN] 1547-4127
  • [Journal-full-title] Thoracic surgery clinics
  • [ISO-abbreviation] Thorac Surg Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor
  • [Number-of-references] 24
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12. Billmire D, Vinocur C, Rescorla F, Colombani P, Cushing B, Hawkins E, London WB, Giller R, Lauer S: Malignant mediastinal germ cell tumors: an intergroup study. J Pediatr Surg; 2001 Jan;36(1):18-24
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  • [Title] Malignant mediastinal germ cell tumors: an intergroup study.
  • PURPOSE: This review was conducted to determine clinical characteristics and response to therapy in this rare pediatric neoplasm.
  • METHODS: An intergroup Pediatric Oncology Group (POG) 9049/Children's Cancer Study Group (CCG) 8882 randomized trial was conducted to evaluate response rate and survival with chemotherapy using etoposide, bleomycin, and high or standard dose cisplatin for high-risk malignant germ cell tumors at extragonadal sites.
  • For this review, a secondary analysis of clinical and operative findings in patients with primary site in the mediastinum was carried out.
  • RESULTS: Of the 38 children with malignant mediastinal germ cell tumors (MGCT), 36 had sufficient data to be included in this review.
  • Thirty-four tumors were anterior mediastinal, 2 were intrapericardial.
  • Yolk sac tumor was the only malignant element in girls.
  • Boys had yolk sac tumor in 7, germinoma in 3, choriocarcinoma in 2, and mixed malignant elements in 15.
  • Benign teratoma elements coexisted in 22 patients.
  • Four patients had biopsy and chemotherapy without tumor resection, and only 1 survived.
  • Fourteen patients had resection at diagnosis followed by chemotherapy with 12 survivors.
  • Eighteen patients had biopsy followed by chemotherapy and postchemotherapy tumor resection with 13 survivors.
  • Tumor size in response to chemotherapy for these 18 patients was stable or increased in 6, and decreased in 12 (mean decrease of 57% in greatest dimension).
  • CONCLUSIONS: Malignant MGCT is a complex tumor of varied histology with frequent coexistence of benign elements.
  • Lesions often have incomplete regression with chemotherapy alone.
  • Tumor resection may be undertaken at diagnosis or after attempted shrinkage with chemotherapy.
  • Aggressive attempt at complete tumor resection should be offered to all patients even if bulky tumor persists after induction chemotherapy with expectation of a significant salvage rate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mediastinal Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Biopsy. Bleomycin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Infant, Newborn. Male. Survival Rate. Treatment Outcome

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  • (PMID = 11150432.001).
  • [ISSN] 0022-3468
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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13. El-Lamie IK, Shehata NA, Abou-Loz SK, El-Lamie KI: Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University. Eur J Gynaecol Oncol; 2000;21(6):605-9
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  • [Title] Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University.
  • PURPOSE: To evaluate the role of extended surgical staging in patients with malignant ovarian germ cell tumors in the presence of cisplatinum-based combination chemotherapy.
  • MATERIALS & METHODS: 16 patients aged between 13 and 40 years (mean 20.5) diagnosed and treated for malignant ovarian germ cell tumors at the Gynecologic Oncology Unit.
  • RESULTS: Six patients were diagnosed with dysgerminoma, six with immature teratoma and four with endodermal sinus tumor.
  • However, the remaining nine cases were referred to the unit, six after having unilateral salpingo-oophorectomy and no surgical staging, one patient after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO), and one with recurrent dysgerminoma in the retroperitoneum and mediastinum following suboptimal treatment.
  • None of these cases were surgically re-explored and all including the first six cases were given the standard BEP chemotherapy for 4-6 courses (mean 5.8).
  • All patients are alive without any evidence of disease recurrence except for one patient with a stage IIIA immature teratoma who had a local and distant recurrence and is undergoing second-line chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Germinoma / surgery. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Egypt. Etoposide / administration & dosage. Female. Follow-Up Studies. Humans. Neoplasm Staging. Reoperation. Retrospective Studies. Treatment Outcome

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  • (PMID = 11214621.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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14. Chetaille B, Massard G, Falcoz PE: [Mediastinal germ cell tumors: anatomopathology, classification, teratomas and malignant tumors]. Rev Pneumol Clin; 2010 Feb;66(1):63-70

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  • [Title] [Mediastinal germ cell tumors: anatomopathology, classification, teratomas and malignant tumors].
  • Mediastinal germ cell tumors are rare tumors.
  • It is classic to divide those tumors into two categories, seminomas and nonseminomatous germ cell tumors: teratomas (mature or immature), embryonal carcinomas, yolk sac tumors, and choriocarcinomas.
  • Each histological sub-type can be associated to another sub-type that realise a so-called mixed germ cell tumor.
  • Diagnosis strategy is currently well codified for malignant mediastinal germ cell tumors.
  • For instance, the treatment strategy still raises some specific problems to each histological type.
  • The treatment of seminomatous tumors is standardised--chemotherapy/surgery on residual tumor greater than 3 cm/radiotherapy on viable persistent residual tumors--and provides very satisfying results.
  • The treatment strategy is less standardised--association of chemotherapy and surgery--and the prognosis is very severe.
  • [MeSH-major] Mediastinal Neoplasms / pathology. Neoplasms, Germ Cell and Embryonal / pathology
  • [MeSH-minor] Biomarkers, Tumor / analysis. Combined Modality Therapy. Humans. Mediastinum / pathology. Neoplasm Invasiveness. Prognosis. Seminoma / classification. Seminoma / pathology. Seminoma / therapy. Teratoma / classification. Teratoma / pathology. Teratoma / therapy. Tomography, X-Ray Computed

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  • [Copyright] Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.
  • (PMID = 20207298.001).
  • [ISSN] 0761-8417
  • [Journal-full-title] Revue de pneumologie clinique
  • [ISO-abbreviation] Rev Pneumol Clin
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 18
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15. Hiroshima K, Toyozaki T, Iyoda A, Yusa T, Fujisawa T, Ohwada H: Apoptosis and proliferative activity in mature and immature teratomas of the mediastinum. Cancer; 2001 Oct 1;92(7):1798-806
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  • [Title] Apoptosis and proliferative activity in mature and immature teratomas of the mediastinum.
  • BACKGROUND: Mediastinal teratomas are the most frequent mediastinal germ cell tumor.
  • Whereas mature teratomas are benign tumors, immature teratomas are malignant.
  • The purpose of this study was to find characteristics that could be used to distinguish between the growth and prognosis of the two teratoma types.
  • METHODS: Twenty-four mediastinal teratomas (18 mature and 6 immature) were examined for apoptosis by 3'-end labeling of DNA and stained immunohistochemically for proliferating cell nuclear antigen, Bcl-2, Bax, p53 protein, and alpha-fetoprotein (AFP) expression in formalin fixed, paraffin embedded specimens.
  • RESULTS: AFP was expressed in both immature teratomas and mature teratomas.
  • Whereas p53 protein was expressed by most teratomas, p53 gene mutation was observed in only one patient with an immature teratoma in which the same mutation occurred in all tumor tissue components tested.
  • Bax protein expression was relatively diffuse in mature teratomas but was focally expressed in immature teratomas.
  • Bcl-2 protein was expressed focally in both mature and immature teratomas.
  • Although the proliferative index was significantly higher in immature teratomas compared with mature teratomas (P < 0.001), the apoptotic index (AI) was significantly higher in mature teratomas compared with immature teratomas (P < 0.05).
  • In contrast, immature teratomas exhibited higher proliferative activity and lower rates of apoptosis, which may explain the more aggressive behavior of these tumors.
  • However, patients with immature mediastinal teratomas have a good prognosis if the tumor is resected completely after chemotherapy.
  • [MeSH-major] Mediastinal Neoplasms / pathology. Teratoma / pathology

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  • [Copyright] Copyright 2001 American Cancer Society.
  • (PMID = 11745252.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BAX protein, human; 0 / DNA, Neoplasm; 0 / Proliferating Cell Nuclear Antigen; 0 / Proto-Oncogene Proteins; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Tumor Suppressor Protein p53; 0 / alpha-Fetoproteins; 0 / bcl-2-Associated X Protein
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16. Michel M, Pratt JW: Anterior mediastinal nonseminomatous germ cell tumor with malignant transformation: a case report. Curr Surg; 2004 Nov-Dec;61(6):576-9
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  • [Title] Anterior mediastinal nonseminomatous germ cell tumor with malignant transformation: a case report.
  • OBJECTIVE: We report a case of a 21-year-old man who presented with the unusual symptoms of heart failure and was found to have an anterior mediastinal yolk sac tumor.
  • RESULTS: The patient was treated with the current standard of neoadjuvant chemotherapy: bleomycin, etoposide, and cisplatin (BEP) with marked reduction in tumor size, followed by en bloc surgical resection.
  • The final pathology revealed teratoma with malignant change: chondrosarcoma, adenocarcinoma, and poorly differentiated sarcoma.
  • CONCLUSIONS: This is a rare initial presentation of an anterior mediastinal germ-cell tumor with treatment consisting of neoadjuvant therapy and surgical resection.
  • In addition, we present the adverse and extremely rare malignant degeneration of this tumor.
  • [MeSH-major] Endodermal Sinus Tumor / pathology. Mediastinal Neoplasms / pathology
  • [MeSH-minor] Adult. Cell Transformation, Neoplastic / pathology. Heart Failure / etiology. Humans. Male. Mediastinum / pathology. Neoplasm Metastasis. Teratoma / pathology

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  • (PMID = 15590027.001).
  • [ISSN] 0149-7944
  • [Journal-full-title] Current surgery
  • [ISO-abbreviation] Curr Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 17
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17. Wei S, Carroll W, Lazenby A, Bell W, Lopez R, Said-Al-Naief N: Sinonasal teratocarcinosarcoma: report of a case with review of literature and treatment outcome. Ann Diagn Pathol; 2008 Dec;12(6):415-25
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  • [Title] Sinonasal teratocarcinosarcoma: report of a case with review of literature and treatment outcome.
  • Sinonasal teratocarcinosarcoma is a highly malignant, polymorphous neoplasm that combines features of carcinosarcoma and teratoma.
  • Computerized tomography scans and magnetic resonance imaging revealed a large mass filling the left nasal cavity and extending to the cribriform plate with involvement of the ethmoid sinuses, lamina papyracea, and orbit.
  • The patient underwent a complex procedure for a T3N0 tumor.
  • Immature neuroepithelium and olfactory neuroblastomalike tissue are highlighted with neuroendocrine markers.
  • Postoperatively, the patient had a rapid local recurrence of the tumor and underwent reexcision, and was treated with radiotherapy and chemotherapy.
  • Twelve months after his primary resection, computerized tomography scans revealed an intrathoracic tumor with dominant mass in the left hilum and metastases to the mediastinum, left pleural space, and both lungs.
  • Among 54 cases of reported sinonasal teratocarcinosarcoma, 67% of patients with initial single surgical resection and 80% of patients primarily treated with radiotherapy had recurrence, or metastatsis, or unresponsiveness to treatment.
  • Almost half of the patients died of tumor within 3 years of diagnosis, despite aggressive therapy.
  • Seventy percent of the patients who survived more than 1 year had the initial therapeutic regiments of combined surgery and adjuvant therapies, suggesting that aggressive therapeutic approaches may improve the treatment outcome.
  • [MeSH-major] Carcinosarcoma / diagnosis. Carcinosarcoma / therapy. Nose Neoplasms / diagnosis. Nose Neoplasms / therapy. Teratoma / diagnosis. Teratoma / therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Paranasal Sinuses / pathology. Paranasal Sinuses / surgery. Prognosis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 18995206.001).
  • [ISSN] 1532-8198
  • [Journal-full-title] Annals of diagnostic pathology
  • [ISO-abbreviation] Ann Diagn Pathol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 33
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18. Schneider DT, Calaminus G, Reinhard H, Gutjahr P, Kremens B, Harms D, Göbel U: Primary mediastinal germ cell tumors in children and adolescents: results of the German cooperative protocols MAKEI 83/86, 89, and 96. J Clin Oncol; 2000 Feb;18(4):832-9
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  • [Title] Primary mediastinal germ cell tumors in children and adolescents: results of the German cooperative protocols MAKEI 83/86, 89, and 96.
  • PURPOSE: To evaluate children and adolescents with primary mediastinal teratoma and malignant germ cell tumors (GCTs).
  • Teratoma (n = 21) were resected, and no adjuvant treatment was given.
  • Malignant GCTs (n = 26) were treated with cisplatin-based chemotherapy and resection.
  • RESULTS: In all patients with teratoma, tumor markers were normal.
  • Surgery of teratoma was complete in 17 of 21 patients and microscopically incomplete in four of 21 patients, and we observed no relapse after a median follow-up of 29 months.
  • In 23 of 26 patients with malignant GCTs, alpha-fetoprotein and/or beta-human chorionic gonadotropin were elevated.
  • Twelve of 26 patients received adjuvant chemotherapy after initial resection, which was complete in six of 12 patients, whereas delayed resection after preoperative chemotherapy was complete in 10 of 11 patients (P =.03).
  • For all malignant GCTs, the 5-year survival rate was 0.87 +/- 0.05 (median follow-up, 51 months), with an EFS of 0.83 +/- 0.05.
  • CONCLUSION: The prognosis of mediastinal teratoma is excellent after complete or microscopically incomplete resection.
  • In children with malignant GCT, the prognosis is favorable with a therapeutic strategy of delayed resection after preoperative chemotherapy.
  • In most children, the diagnosis can be based on elevated tumor markers and imaging.
  • [MeSH-major] Germinoma / surgery. Mediastinal Neoplasms / surgery. Teratoma / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Child. Child, Preschool. Chorionic Gonadotropin, beta Subunit, Human / analysis. Cisplatin / therapeutic use. Cohort Studies. Female. Follow-Up Studies. Humans. Infant. Infant, Newborn. Male. Neoplasm Recurrence, Local / pathology. Neoplasm, Residual. Prognosis. Prospective Studies. Radiotherapy, Adjuvant. Remission Induction. Survival Rate. Treatment Outcome. alpha-Fetoproteins / analysis

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  • (PMID = 10673525.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins; Q20Q21Q62J / Cisplatin
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19. Michael H, Lucia J, Foster RS, Ulbright TM: The pathology of late recurrence of testicular germ cell tumors. Am J Surg Pathol; 2000 Feb;24(2):257-73
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  • A total of 91 men had histologically documented late recurrences of testicular germ cell tumors characterized by a complete response to treatment with a subsequent disease-free interval of at least 2 years and no evidence of a second primary lesion.
  • Ninety percent of the patients for whom information was available received chemotherapy shortly after their initial diagnosis of testicular germ cell tumors; most of the other patients were known to have stage I disease initially.
  • Overall, 60% of patients had teratoma in their late recurrences, including 20 patients (22%) in whom teratoma was the only element.
  • Thus, teratoma was the most common type of neoplasm in late recurrences.
  • Excluding teratoma coexisting with other types of neoplasms, yolk sac tumor was the most frequent type of tumor in patients with late recurrence.
  • It occurred in 47% of patients, either alone or with teratoma, another nonteratomatous germ cell tumor type, or a "nongerm cell malignant tumor."
  • Unusual types of yolk sac tumor, including glandular, parietal, clear cell, and pleomorphic patterns, were seen frequently in late recurrences and often raised differential diagnostic problems with "nongerm cell" carcinomas.
  • A smaller number of late recurrences consisted of other types of neoplasms.
  • Twenty percent of patients with late recurrence had a nonteratomatous germ cell tumor other than yolk sac tumor, either alone, with yolk sac tumor, or with a "nongerm cell malignant tumor."
  • "Nongerm cell malignant tumors," including both sarcomas and carcinomas of various types, occurred in 23% of late-recurrence patients, either alone or with a nonteratomatous germ cell tumor.
  • Late recurrences were seen in many different sites in these patients, including the retroperitoneum, abdomen, pelvis, liver, mediastinum, lung, bone (femur, vertebra, and rib), lymph nodes outside the retroperitoneum and mediastinum (supraclavicular, neck, and axillary regions), scrotum and inguinal regions, adrenal gland, chest wall, and buttocks.
  • Patients whose late recurrences consisted of teratoma only had the most favorable outcomes, with 79% having no evidence of disease at last follow-up.
  • Patients whose late recurrences consisted of pure "nongerm cell malignant tumor" or pure germ cell tumor (yolk sac tumor or other types) had a much worse prognosis: Only 36% to 37% were alive with no evidence of disease.
  • Patients with two different types of nonteratomatous malignancies in their late recurrences had a dismal clinical course: Only 17% with both yolk sac tumor and other nonteratomatous germ cell tumor had no evidence of disease, whereas no patient with both nonteratomatous germ cell tumor and "nongerm cell malignant tumor" was disease free.
  • Late recurrences consisting of teratoma alone often have a favorable outcome, but the prognosis in all other patients is poor.
  • Furthermore, late recurrence is not likely to respond to chemotherapy and is best treated by surgical excision when possible.
  • [MeSH-minor] Adolescent. Adult. Carcinoma, Embryonal / complications. Carcinoma, Embryonal / pathology. Carcinoma, Embryonal / therapy. Choriocarcinoma / complications. Choriocarcinoma / pathology. Choriocarcinoma / therapy. Endodermal Sinus Tumor / complications. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / therapy. Fluorescent Antibody Technique, Direct. Humans. Male. Neoplasm Staging. Neoplasms, Second Primary / pathology. Neoplasms, Second Primary / therapy. Sarcoma / complications. Sarcoma / pathology. Sarcoma / therapy. Seminoma / complications. Seminoma / pathology. Seminoma / therapy. Teratoma / complications. Teratoma / pathology. Teratoma / therapy

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  • (PMID = 10680894.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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20. Malagón HD, Valdez AM, Moran CA, Suster S: Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol; 2007 Sep;31(9):1356-62
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  • Twenty-three tumors arose in the mediastinum, 2 in the retroperitoneum, and 21 in the gonads.
  • The germ cell component consisted of pure mature or immature teratoma (23 cases), teratoma mixed with other seminomatous or nonseminomatous components (17), pure seminoma (2), intratubular germ cell neoplasia (1), and yolk sac tumor (1).
  • The SC included embryonal rhabdomyosarcoma (29), angiosarcoma (6), leiomyosarcoma (4), undifferentiated sarcoma (3), myxoid liposarcoma (1), malignant peripheral nerve sheath tumor (1), malignant "triton" tumor (1), and epithelioid hemangioendothelioma (1).
  • All patients were treated by cisplatinum-based chemotherapy plus other agents followed by surgery.
  • [MeSH-major] Immunohistochemistry. Mediastinal Neoplasms / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Ovarian Neoplasms / diagnosis. Retroperitoneal Neoplasms / diagnosis. Sarcoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Orchiectomy. Ovariectomy. Time Factors. Treatment Outcome

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  • (PMID = 17721191.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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