The mediastinum is the most common extragonadal location. In adults, approximately % of mediastinal tumors are germ cell tumors;. 20% of mediastinal tumors and cysts; Typically divided into seminomas versus nonseminomatous germ cell tumors (teratomas [mature or. Mediastinal germ cell tumors are tumors that derive from germ cell rest remnants in the mediastinum. They most commonly occur in the gonad but occasionally.
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Histologic grading of pure teratomas has prognostic significance in those neoplasms that are diagnosed in adolescents and young adults; immature teratomas in the latter germinomx pursue an aggressive clinical course. However, discrepancies between the genetic alterations and immunoprofiles of mediastinal and testicular seminomas have been reported, raising the question of whether techniques that are useful in the diagnosis of gonadal seminoma are applicable to its mediastinal counterpart.
These neoplasms are often associated with mediastiunm thymus, and in many cases appear to have originated in the thymus; residual thymic tissue is not identifiable in the highly invasive and ferminoma germ cell tumor.
Epidemiology Usually males Gross description Invasive, highly necrotic Microscopic histologic description Poorly differentiated, pleomorphic cells with prominent nucleoli, often with eosinophilic intracellular globules or primitive lumina; variable geographic necrosis No nuclear blebs Microscopic histologic images Images hosted on other servers: The treatment for mediastinal nonseminomatous germ cell tumors should follow guidelines for poor-prognosis testicular cancer.
The anterior mediastinum is the most common primary extragonadal site for germinal neoplasms in adults and is second to the sacrococcygeal region for pathologially comparable tumors in children.
Germ cell tumors of the mediastinum.
Epidemiology Usually men in 20s with elevated hCG and gynecomastia, impotence Prognostic factors Poor prognosis Case reports 13 year old boy with shortness of breath, chest pain, fever, irritable cough and weight loss Zhongguo Dang Dai Er Ke Za Zhi ; Page views in to date: These tumors are highly sensitive to radiation therapy and to combination chemotherapy.
However, the cardiotoxicity of mediastinal radiation is substantial and the standard treatment of mediastinal seminomas is with chemotherapy using bleomycinetoposide and cisplatin for either three or four day treatment cycles depending on geminoma location of any metastatic disease.
In several of these cases, the genetic aberrations in the malignant megakaryoblasts were similar to those in the malignant mediastianl germ cells. Unlike benign germ cell tumors of the mediastinum, malignant mediastinal tumors are usually symptomatic at the time of diagnosis.
These results and those of other analyses suggest that the two malignancies derive from a common founding clone of cells i. Metastatic germ cell tumor: Views Read Edit View history.
Mediastinal germ cell tumor – Wikipedia
May have aggressive gerjinoma if not limited to mediastinum at diagnosis Cancer ; Click here for patient related inquiries. Info – Admin Resources in pathology Technical section.
Among the malignant germ cell tumors, males are affected far more commonly than females, but the male to female ratio is approximately equal among mature cystic teratomas. Wikipedia articles that are too technical from April All articles that are too technical Articles needing expert attention from April All articles needing expert attention Infobox medical condition All articles with vague or ambiguous time Vague or ambiguous time from April Unencapsulated, homogenous fleshy mass with indistinct boundaries and invasion of adjacent structures, hemorrhage or necrosis.
Syndromes associated with mediastinal germ cell tumors include Hematologic Neoplasia and Klinefelter’s syndrome. Others hypothesize a widespread distribution of germ cells to multiple sites during normal embryogenesis, with these cells conveying genetic information or providing regulatory functions at somatic sites.
Pancoast tumor Solitary pulmonary germinoa Central lung Peripheral lung Bronchial leiomyoma. Immunohistochemical staining for OCT4 has recently been validated as a powerful tool for detecting gonadal seminoma.
Mediastinal germ cell tumor
Usually males ages 20 – 49 years, similar to gonadal tumors Cancer ; New author database being installed, click here for details. Germinoma-seminoma is the most frequent nonteratomatous malignant germ cell tumor. Non-small-cell gedminoma carcinoma Squamous-cell carcinoma Adenocarcinoma Mucinous cystadenocarcinoma Large-cell lung carcinoma Rhabdoid carcinoma Sarcomatoid carcinoma Carcinoid Salivary gland—like carcinoma Adenosquamous carcinoma Papillary adenocarcinoma Giant-cell carcinoma.
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Thymic seminoma with marked cystic changes, superior mediastinum. Seminomas grow relatively slowly and can become very large before causing symptoms. Initial treatment with four courses of bleomycin, etoposide, and cisplatin, followed by surgical resection of any residual disease, is considered standard therapy.
In these cases, the mediastinal germ cell tumor develops before or concomitantly with but not after acute megakaryoblastic leukemia. Am J Surg Pathol.