What is the malignant transformation (or somatic malignancy) of germ cell tumors? What is the clinical significance of this transformation?
Malignant transformation in adult germ cell tumors (GCTs) refers to the development of a new type of neoplasm of somatic cell differentiation. It can be found in the orchiectomy specimen as well as the postchemotherapy retroperitoneal lymph nodes because of its refractoriness to the cisplantin-based chemotherapy. The most frequently reported types are rhabdomyosarcoma, sarcomas not otherwise classified, primitive neuroectodermal tumor, and adenocarcinoma. Their origin from GCTs is supported by demonstrating i(12p) chromosome in the tumor cells. Clinically, occurrence of malignant transformation is suspected when there is evidence of tumor progression despite improved tumor markers. Cure or long-term survival may be expected if the tumor is removed surgically. Chemotherapy optimal against the tumor of concern should be considered for patients with advanced-stage cancer.
KeywordsGerm Cell Tumor Primitive Neuroectodermal Tumor Immature Teratoma Retroperitoneal Lymph Node Dissection Mixed Germ Cell Tumor
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