Extragonadal Germ Cell Tumors: A Review With Emphasis on Pathologic Features, Clinical Prognostic Variables, and Differential Diagnostic Considerations

Abstract

Extragonadal germ cell tumors (GCTs) are relatively uncommon, but represent 1% to 5% of all GCTs. Their morphology varies widely and includes mature teratoma, immature teratoma, seminoma, yolk sac tumor, embryonal carcinoma, choriocarcinoma, and mixed GCTs. Noncentral nervous system extragonadal GCTs are found in a variety of anatomic locations, but most commonly affect the mediastinum and sacrococcygeal region. Predicting behavior in these tumors can be confusing because it is based on a combination of varying factors including patient age, histologic subtype, anatomic site, and clinical stage. This review attempts to dissect these issues by separating the discussion into 3 age groups: neonatal (congenital), children (prepubertal), and adult (postpubertal). Within each individual age group, we cover the significance of anatomic site, morphology, and staging parameters. In addition, we discuss the spectrum of associated secondary malignancies and their impact on patient outcome. Finally, we provide a detailed survey of differential diagnostic considerations grouped by anatomic site.

Extragonadal teratomas of the adult abdomen and pelvis: a pictorial review

“…4 Retroperitoneal MCTs (Figure 3) are also more common in childhood accounting for ,5% of all extragonadal GCTs. 1 They may cause considerable diagnostic confusion, if thought to represent Wilms' tumours or neuroblastomas. 2 These MCTs are rare in adults and are seen more frequently in females.…”

“…6 In prepubertal children, the immature elements within a teratoma are not associated with malignant behaviour; however, in adults, mediastinal immature teratomas can be aggressive with a poor prognosis. 1,7 More rarely, teratomas may contain frankly malignant components of several tissue lineages. Generally, cystic teratomas are more likely to be benign and solid teratomas more likely to be malignant.…”

“…Extragonadal abdominopelvic teratomas are, in contrast, very rare and are seen in both sexes. They represent only 1-5% of germ cell tumours (GCTs) 1 and therefore may not be readily considered by clinicians. Their radiological appearances are, however, characteristic, and familiarity with these features will lead to more accurate radiological diagnoses that not only guide treatment but also prevent avoidable complications from diagnostic delay.…”

Hemoptise em um paciente com microlitíase testicular e tumor de células germinativas: uma combinação rara

“…In general, the tumors that are the most likely to become malignant are those that are found in the anterior compartment and those that are accompanied by symptoms. (1) We recently treated a patient diagnosed with a primary seminomatous germ cell tumor (GCT) accompanied by testicular microlithiasis (TM). To our knowledge, there are only six published cases documenting an association between primary seminoma of the mediastinum and TM.…”

A Case Report of Retroperitoneal Seminoma and Literature Review

“…These tumours are predominantly non-seminomatous in histology, occur frequently in patient with Klinefelter's syndrome and are frequently associated with the development of haematological malignancies [3,4].…”