Extragonadal germ cell tumor of the posterior mediastinum in a child complicated with spinal cord compression: a case report

Yon, Dong Keon; Ahn, Tae Keun; Shin, Dong Eun; Kim, Gwang Il; Kim, Moon Kyu

doi:10.1186/s12887-018-1070-6

Cited by 5 publications

(10 citation statements)

References 18 publications

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“…We report about an adolescent patient who died of metastatic malignant melanoma arising from a mediastinal malignant teratoma after two courses of chemotherapy without re-elevation in tumor markers, including AFP. There are few reported cases of malignant melanoma arising from ovarian cystic teratomas [2, 5–10], with Algeri et al reporting 49 cases in their review article. However, to our knowledge, this is only the second reported case of melanoma arising from a malignant mixed germ cell tumor of the anterior mediastinum [11].…”

Section: Discussionmentioning

confidence: 99%

“…Primary mediastinal germ cell tumors (GCTs) are rare and account for approximately 5% of all extragonadal GCTs. In addition, they account for approximately 25% of mediastinal tumors in children, including 60% of mature teratoma, 20% of mixed GCTs, and 20% of embryonal carcinoma (including seminoma/germinoma, immature teratoma, yolk sac tumor, and choriocarcinoma) [1, 2]. The prognosis of mediastinal GCTs is poor compared to that of gonadal nonseminomatous GCTs (NSGCTs) [3, 4] because the 5-year overall survival rate of mediastinal GCTs is much lower than that of gonadal NSGCTs.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

Nozaki

Tone

Yamanaka

et al. 2018

Case Reports in Pediatrics

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We report about a 14-year-old boy who presented with an anterior mediastinal mass that was diagnosed as malignant teratoma. Surgical resection was performed along with pre- and postoperative chemotherapy. Although elevated alpha-fetoprotein became negative, he experienced pain in his right hip joint 3 months after resection. Systematic evaluation revealed multiple locations of metastasis, and the pathological diagnosis based on bone biopsy was malignant melanoma originating from malignant teratoma, which rapidly progressed. He died 15 months after diagnosis of the original malignant teratoma. Diagnosing and treating malignant transformation of teratoma, including malignant melanoma, is difficult because it is very rare. To our knowledge, this is the second reported case of malignant melanoma arising from a mediastinum malignant teratoma, with both cases having a poor prognosis. In addition to the follow-up of tumor markers, systematic evaluation, including imaging, should be considered even after remission to monitor malignant transformation of teratoma. We expect to establish a successful therapy and improve mortality rate after more such cases are accumulated.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

Nozaki

Tone

Yamanaka

et al. 2018

Case Reports in Pediatrics

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“…The patient recovered postoperatively with mild kyphotic curvature and 4/5 strength in his lower extremities at 3 years postoperatively. 12 …”

Section: Discussionmentioning

confidence: 99%

Primary Extramedullary, Extradural Cervical Spine Seminoma

Long

Novack²,

Changoor³

et al. 2020

JAAOS Glob Res Rev

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While extragonadal seminomas resulting in spinal cord compression are rarely reported in the literature, most have been treated with surgical decompression followed by radiation therapy. In this report, we present the unique and interesting case of a 38-year-old man who initially presented as an outpatient with a chief complaint of axial neck pain and lateral thoracic wall pain. After an extensive malignancy workup, he was diagnosed with a primary cervical spine seminoma and was treated with a C6–T1 laminectomy with posterior spinal instrumentation from C5 to T2. He has since undergone chemotherapy with cisplatin, vinblastine, and bleomycin, and at 24-month follow-up, he remains asymptomatic with no signs of recurrent disease.

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“…Systemic EST has occasionally been reported to metastasize to the spine [3]. There are few previously reported cases of EST in children and adults presenting with spinal cord compression [2,3,[5][6][7]. In this article, we report a 28-monthold boy with primary EST located in the retroperitoneal region presenting with thoracic spinal cord compression.…”

Section: Introductionmentioning

confidence: 92%

Extragonadal germ cell tumor presenting with spinal cord compression: a case report and literature review

et al. 2022

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Background Yolk sac tumor or endodermal sinus tumor is an uncommon malignant germ cell neoplasm. This tumor usually presents in childhood or young adulthood as a testicular or ovarian mass. Extragonadal sites such as mediastinal, intracranial, and sacrococcygeal have been described. A review of the literature revealed limited related cases. The clinical presentation, radiographic characteristics, operative findings, and patient outcomes are discussed. Case presentation We report the occurrence of a primary paraspinal germ cell tumor in a 28-month-old boy who presented with thoracic spinal cord compression. The patient presented with pain, weakness, paraplegia, and bowel and bladder disturbances. MRI was done and showed a retroperitoneal and paravertebral mass invading the left diaphragmatic crus, the lateral neural foramen, and the posterior paravertebral muscles. Morphologic and immunohistochemical features were consistent with a germ cell tumor, namely an endodermal sinus tumor (yolk sac) of the epidural area. The final diagnosis was determined to be stage IV extragonadal germ cell tumor. The patient underwent emergency surgery consisting of T10–12 laminectomy and epidural mass resection with the release of the spinal cord compression and received chemotherapy consisting of cisplatin, bleomycin, and etoposide. After six cycles of chemotherapy, follow-up MRI showed complete resolution of the tumor. The patient has been in complete remission 16 years from his initial diagnosis. He still, however, has mild residual weakness in both lower extremities and some detrusor-sphincter dyssynergia. Conclusion Extragonadal germ cell tumors presenting with spinal cord compression are rare; however, they should be included in the differential diagnosis of every child younger than 3 years old who does not present with the typical features. Germ cell tumors are sensitive to platinum-based chemotherapy, and surgery should only be performed for spinal cord compression and for obtaining tissue biopsy for a definitive diagnosis. The sooner the decompression is done, the better neurological outcome is achieved. Long-term remission, and possibly cure, can be achieved with a multidisciplinary treatment strategy.

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Extragonadal germ cell tumor of the posterior mediastinum in a child complicated with spinal cord compression: a case report

Cited by 5 publications

References 18 publications

A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

Primary Extramedullary, Extradural Cervical Spine Seminoma

Extragonadal germ cell tumor presenting with spinal cord compression: a case report and literature review

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