Cervical metastasis of germ cell tumors: Evaluation, management, complications, and outcomes

Mehra, Saral; Liu, Jeffrey; Gupta, Amit; Sheinfeld, Joel; Kraus, Dennis H.

doi:10.1002/lary.22422

Cited by 5 publications

(10 citation statements)

References 13 publications

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“…Because testicular carcinoma is the most common malignancy in men aged 20 to 30 years, a left supraclavicular mass in this age group should raise suspicion for a concomitant testicular mass. 12 Mehra et al 13 conducted a retrospective review and found that 74% of patients had a neck mass at the initial diagnosis, and 67% of those had a neck mass as the presenting symptom, leading to a diagnosis of GCTs. In their study, preoperative tumor markers were also obtained and were normal in 58% of the patients, and were not significantly correlated with positive neck pathology, disease-specific survival, or overall survival.…”

Section: Discussionmentioning

confidence: 99%

Cervical malignant teratoma masquerading as a hematoma: a case report

2021

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Background Post-pubertal teratomas, which mostly occur at 20 to 40 years old, are more likely to be found at a metastatic site in up to 20% of cases and may be inadvertently overlooked. We present a case of cervical malignant teratoma that masqueraded as a hematoma. Case presentation: A 24-year-old man presented to our institution with a 4-month history of a progressively relapsing painless mass in the neck, despite conservative treatments with oral medications. A huge space-occupying mass was identified with almost total occlusion of the left internal jugular vein. The likely diagnosis was an organized hematoma or congenital cystic tumor with internal hemorrhage. Surgical excisional biopsy of the mass lesion was conducted and a malignant teratoma was found. A whole-body positron emission tomography scan showed a left inguinal mass, bilateral intra-abdominal lymphadenopathies, and abdominal metastases. Histopathology further suggested the diagnosis of an immature testicular teratoma with multiple lymph node metastases. The patient received adjuvant chemotherapy with a bleomycin, etoposide, and cisplatin regimen. During follow-up, salvage second-line chemotherapy was required with a paclitaxel, ifosfamide, and cisplatin regimen. Conclusion Although uncommon, cervical teratoma should be taken into consideration once a painless and non-remitting mass lesion is found in a young adult.

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Section: Discussionmentioning

confidence: 99%

Cervical malignant teratoma masquerading as a hematoma: a case report

2021

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“…Using this approach, disease in the chest, if present, is resected at another time instead of at the same time as concurrent neck and RPLND. In a series of neck dissections, Mehra and colleagues 15 performed an RPLND concurrently in 50% of patients. Neck surgery can also be combined with thoracic surgery for metastatic GCT.…”

Section: Concurrent Surgerymentioning

confidence: 99%

“…The complication rates after excising neck masses has been reported to be 0% to 9%. 15,31 Surgery may require sacrificing adjacent structures, such as the spinal accessory nerve, internal jugular vein, or sternocleidomastoid muscle. Chyle leakage has been reported in up to 4% cases.…”

Section: Neckmentioning

confidence: 99%

Role of Extraretroperitoneal Surgery in Patients with Metastatic Germ Cell Tumors

Daneshmand

2015

Urologic Clinics of North America

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“…In a retrospective study of 34 patients with GCT metastatic to the neck who underwent postchemotherapy neck dissection between 1991 and 2009, Mehra et al . [ 22 ] showed no cervical region recurrence after 52 months of median follow-up. In a retrospective review of 45 patients of metastatic NSGCT who underwent 48 unilateral and 3 bilateral neck dissections, Weisberger and McBride[ 23 ] concluded that surgical resection of neck PCRD leads to surprisingly favorable prognosis.…”

Section: Rational Of Surgical Excision Of Nonretroperitoneal Postchemmentioning

confidence: 99%

Surgical controversies in the management of post-chemotherapy nonretroperitoneal residual disease in metastatic nonseminomatous germ cell tumors

Pandey

Garg

Ray

et al. 2016

South Asian J Cancer

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Following the advent of platinum-based chemotherapy, Surgery, excepting orchidectomy, has become an adjunct treatment in the management of metastatic non-seminomatous germ cell tumors (NSGCT). Role of surgery comes into play in metastatic NSGCT when residual disease persists following standard chemotherapy. Surgical excision of all post chemotherapy residual disease at all places, whenever surgically feasible with acceptable morbidity and mortality, should be undertaken. As histopathological examination of the excised postchemotherapy residue shows only necrosis and fibrosis in significant number of patients; surgical exercise in this group of patients seems futile and unwarranted retrospectively. This issue becomes more contentious when surgeons are confronted with multiple nonretroperitoneal post chemotherapy residues. This article aims to deal with the management of postchemotherapy nonretroperitoneal residues in metastatic NSGCT.

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Cervical metastasis of germ cell tumors: Evaluation, management, complications, and outcomes

Abstract: Operative management for patients with metastatic GCT to the neck can achieve long-term durable cervical control with limited complications.

Cited by 5 publications

References 13 publications

Cervical malignant teratoma masquerading as a hematoma: a case report

Cervical malignant teratoma masquerading as a hematoma: a case report

Role of Extraretroperitoneal Surgery in Patients with Metastatic Germ Cell Tumors

Surgical controversies in the management of post-chemotherapy nonretroperitoneal residual disease in metastatic nonseminomatous germ cell tumors

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