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Primitive Mediastinal Germ Cell Tumors: An Update

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Book cover The Mediastinal Mass

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Abstract

Mediastinal germ cell tumors are a heterogeneous group of neoplasm including seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma, and mixed germ cell tumors. Although mediastinal germ cell tumors are rare, they represent a significant amount of primary mediastinal neoplasms. Clinical symptoms appear late, and the neoplasms are often accidentally found during imaging examination performed for other causes. Laboratory tests are helpful because some serological markers, like AFP, β-hCG, and LDH, are often associated with germ cell tumors. Nevertheless, diagnosis is actually based on the direct sampling of neoplastic cells or tissue, and pathological examination is mandatory.

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References

  1. Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. WHO classification of tumours of the lung, pleura, thymus and heart. 4th ed. Lyon: IARC; 2015.

    Google Scholar 

  2. 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;97(2):367–76.

    Article  Google Scholar 

  3. Marchevsky AM, Wick MR. Pathology of the mediastinum. Cambridge: Cambridge University Press; 2014.

    Book  Google Scholar 

  4. Knapp RH, Hurt RD, Payne WS, Farrow GM, Lewis BD, Hahn RG, et al. Malignant germ cell tumors of the mediastinum. J Thorac Cardiovasc Surg. 1985;89(1):82–9.

    CAS  PubMed  Google Scholar 

  5. Willis RA. The borderland of embryology and pathology. Bull N Y Acad Med. 1950;26(7):440–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Oosterhuis JW, Stoop H, Honecker F, Looijenga LH. Why human extragonadal germ cell tumours occur in the midline of the body: old concepts, new perspectives. Int J Androl. 2007;30(4):256–63.

    Article  Google Scholar 

  7. Aguirre D, Nieto K, Lazos M, Peña YR, Palma I, Kofman-Alfaro S, et al. Extragonadal germ cell tumors are often associated with Klinefelter syndrome. Hum Pathol. 2006;37(4):477–80.

    Article  CAS  Google Scholar 

  8. Sung MT, Maclennan GT, Lopez-Beltran A, Zhang S, Montironi R, Cheng L. Primary mediastinal seminoma: a comprehensive assessment integrated with histology, immunohistochemistry, and fluorescence in situ hybridization for chromosome 12p abnormalities in 23 cases. Am J Surg Pathol. 2008;32(1):146–55.

    Article  Google Scholar 

  9. Looijenga LH, Oosterhuis JW. Pathogenesis of testicular germ cell tumours. Rev Reprod. 1999;4:90–100.

    Article  CAS  Google Scholar 

  10. Taylor MD, Jones DR. Genetic markers of mediastinal tumors. Thorac Surg Clin. 2009;19(1):17–27.

    Article  Google Scholar 

  11. Taylor-Weiner A, Zack T, O'Donnell E, Guerriero JL, Bernard B, Reddy A, et al. Genomic evolution and chemoresistance in germ-cell tumours. Nature. 2016;540(7631):114–8.

    Article  CAS  Google Scholar 

  12. Kawaguchi K, Kishida S, Okeda R, Funata N, Koike M. Encephalomyeloneuritis with mediastinal germ cell tumor. A paraneoplastic condition? Acta Pathol Jpn. 1988;38(3):351–9.

    CAS  PubMed  Google Scholar 

  13. Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, et al., American Society of Clinical Oncology. American Society of Clinical Oncology clinical practice guideline on uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol. 2010;28(20):3388–404.

    Google Scholar 

  14. International Germ Cell Cancer Collaborative Group. International germ cell consensus classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol. 1997;28:207–14.

    Google Scholar 

  15. Reuter VE. The pre and post chemotherapy pathologic spectrum of germ cell tumors. Chest Surg Clin N Am. 2002;12(4):673–94.

    Article  Google Scholar 

  16. Neiman RS, Orazi A. Mediastinal non-seminomatous germ cell tumours: their association with non-germ cell malignancies. Pathol Res Pract. 1999;195(8):589–94.

    Article  CAS  Google Scholar 

  17. Hartmann JT, Fossa SD, Nichols CR, Droz JP, Horwich A, Gerl A, et al. Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors. J Natl Cancer Inst. 2001;93(22):1733–8.

    Article  CAS  Google Scholar 

  18. Bokemeyer C, Nichols CR, Droz JP, Schmoll HJ, Horwich A, Gerl A, et al. Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis. J Clin Oncol. 2002;20(7):1864–73.

    Article  Google Scholar 

  19. Orazi A, Neiman RS, Ulbright TM, Heerema NA, John K, Nichols CR. Hematopoietic precursor cells within the yolk sac tumor component are the source of secondary hematopoietic malignancies in patients with mediastinal germ cell tumors. Cancer. 1993;71(12):3873–81.

    Article  CAS  Google Scholar 

  20. Nichols CR, Roth BJ, Heerema N, Griep J, Tricot G. Hematologic neoplasia associated with primary mediastinal germ-cell tumors. N Engl J Med. 1990;322(20):1425–9.

    Article  CAS  Google Scholar 

  21. McKenney JK, Heerema-McKenney A, Rouse RV. Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations. Adv Anat Pathol. 2007;14(2):69–92.

    Article  Google Scholar 

  22. Bokemeyer C, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, et al. Extragonadal seminoma: an international multicenter analysis of prognostic factors and long term treatment outcome. Cancer. 2001;91(7):1394–401.

    Article  CAS  Google Scholar 

  23. Caraway NP, Fanning CV, Amato RJ, Sneige N. Fine-needle aspiration cytology of seminoma: a review of 16 cases. Diagn Cytopathol. 1995;12(4):327–33.

    Article  CAS  Google Scholar 

  24. Cheng J, Zhu H, Choi JK. CD30 expression in pediatric neoplasms, study of 585 cases. Pediatr Dev Pathol. 2017;20(3):191–6.

    Article  Google Scholar 

  25. Suster S, Moran CA, Dominguez-Malagon H, Quevedo-Blanco P. Germ cell tumors of the mediastinum and testis: a comparative immunohistochemical study of 120 cases. Hum Pathol. 1998;29(7):737–42.

    Article  CAS  Google Scholar 

  26. Moran CA, Suster S. Primary germ cell tumors of the mediastinum: I. Analysis of 322 cases with special emphasis on teratomatous lesions and a proposal for histopathologic classification and clinical staging. Cancer. 1997;80(4):681–90.

    Article  CAS  Google Scholar 

  27. Schneider DT, Schuster AE, Fritsch MK, Calaminus G, Göbel U, Harms D, et al. Genetic analysis of mediastinal nonseminomatous germ cell tumors in children and adolescents. Genes Chromosomes Cancer. 2002;34(1):115–25.

    Article  CAS  Google Scholar 

  28. Zynger DL, Everton MJ, Dimov ND, Chou PM, Yang XJ. Expression of glypican 3 in ovarian and extragonadal germ cell tumors. Am J Clin Pathol. 2008;130(2):224–30.

    Article  Google Scholar 

  29. Wang F, Liu A, Peng Y, Rakheja D, Wei L, Xue D, et al. Diagnostic utility of SALL4 in extragonadal yolk sac tumors: an immunohistochemical study of 59 cases with comparison to placental-like alkaline phosphatase, alpha-fetoprotein, and glypican-3. Am J Surg Pathol. 2009;33(10):1529–39.

    Article  Google Scholar 

  30. Iczkowski KA, Butler SL, Shanks JH, Hossain D, Schall A, Meiers I, et al. Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors. Hum Pathol. 2008;39(2):275–81.

    Article  CAS  Google Scholar 

  31. Yamane H, Ochi N, Honda Y, Takigawa N. Gynecomastia as a paraneoplastic symptom of choriocarcinoma. Intern Med. 2016;55(18):2739–40.

    Article  Google Scholar 

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Correspondence to Renato Franco .

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Ronchi, A., Marino, F.Z., Facchini, G., Accardo, M., Franco, R. (2018). Primitive Mediastinal Germ Cell Tumors: An Update. In: Franco, R., Zito Marino, F., Giordano, A. (eds) The Mediastinal Mass. Current Clinical Pathology. Humana, Cham. https://doi.org/10.1007/978-3-319-90368-2_10

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  • DOI: https://doi.org/10.1007/978-3-319-90368-2_10

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-319-90367-5

  • Online ISBN: 978-3-319-90368-2

  • eBook Packages: MedicineMedicine (R0)

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