scholarly journals Malignant Transformation of Testicular Teratoma to PNET, Adenocarcinoma, and Osteosarcoma with Complete Remission after Surgery and Combination Chemotherapy in a Young Adult Male

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Angela Shaw ◽  
Miriam Morrell ◽  
Annikka Weissferdt ◽  
Andrea Hayes-Jordan ◽  
Douglas Harrison
Keyword(s):  
Germ Cell ◽  
Malignant Transformation ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Metastatic Lesion ◽  
Immature Teratoma ◽  
Targeted Chemotherapy ◽  
Cell Lineages ◽  
Durable Remission ◽  
Mixed Germ Cell Tumors

Mixed germ cell tumors (GCT) with teratoma components can transform into somatic malignancies which can include histologies outside of traditional germ cell lineages. We describe a case of an 18-year-old man with a metastatic testicular GCT with both mature and immature teratoma components containing malignant transformation into multiple histologies including PNET in the primary testicular tumor and osteosarcoma in a separate pulmonary metastatic lesion. Management with targeted chemotherapy resulted in a durable remission. This is the first reported case that we know of a patient with primary PNET malignant transformation with subsequent metastatic transformation to osteosarcoma.

Paraneoplastic Limbic Encephalitis Secondary To Mixed Non-Seminomatous Germ Cell Tumours

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S55-S56
Author(s):  
A Ullah ◽  
S Heneidi ◽  
P Biddinger ◽  
N Patel ◽  
C Wehrle ◽  
...  
Keyword(s):  
Germ Cell ◽  
Limbic Encephalitis ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Primary Malignancy ◽  
Rare Presentation ◽  
Paraneoplastic Limbic Encephalitis ◽  
Nonseminomatous Germ Cell Tumor ◽  
Aortic Lymph Node ◽  
Alteration Of Consciousness

Abstract Casestudy: Testicular tumors account for 1–2% of all tumors in men, with 95% of these being germ cell tumors. The main risk factor for the development of testicular cancer is cryptorchidism. Paraneoplastic limbic encephalitis is a rare sequela of testicular tumor associated with anti-Ma2 and KLH11 antibodies. The most effective treatment for paraneoplastic limbic encephalitis is treatment of the primary malignancy. We present a 41-year-old male that presented to the emergency department with two weeks of episodic alteration of consciousness and memory disturbances. Negative neurologic evaluation and imaging led to concern for a paraneoplastic process from a distant malignancy. CT imaging revealed an enlarged, necrotic para-aortic lymph node and subsequent ultrasound demonstrated a right sided testicular mass. Right radical orchiectomy was performed. Microscopically, the mass consisted of mixed respiratory epithelium, gastrointestinal glands and squamous epithelium with keratinization consistent with a post-pubertal testicular teratoma with associated in-situ germ cell neoplasia. Resection of the para-aortic mass revealed large anaplastic cells with epithelioid features, nuclear pleomorphism and frequent mitoses. Immunostaining was positive for Pan-Keratin and OCT4, consistent with poorly differentiated embryonal carcinoma. Resection of the primary and metastatic disease, as well as treatment with corticosteroids resulted in resolution of the encephalitis. This presentation of severe neurological disturbances in the setting of a metastatic mixed nonseminomatous germ cell tumor represents a rare presentation of paraneoplastic limbic encephalitis.

Cystic Trophoblastic Tumor in a Primary Central Nervous System Post-Chemotherapy Germ Cell Tumor: The First Case Report

2020 ◽  
Vol 28 (8) ◽  
pp. 925-928
Author(s):  
Ramya Gadde ◽  
Kanika Arora ◽  
Michelle Madden Felicella ◽  
Sohrab Arora ◽  
Liang Cheng ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Cell Tumor ◽  
Smooth Muscle Tissue ◽  
Trophoblastic Tumor ◽  
First Case

Cystic trophoblastic tumor (CTT) is an uncommon trophoblastic proliferation of germ cell tumor origin, mostly reported in post-chemotherapy metastases of testicular germ cell tumors and rarely primary untreated testicular tumors. To date, we are not aware of occurrence in a non-testicular tumor. A 12-year-old boy presented with limb swelling, increased appetite, weight gain, and precocious puberty. Evaluation revealed right frontal lobe mass and elevated α-fetoprotein and β-human chorionic gonadotrophin. After response to neoadjuvant chemotherapy, the tumor was resected. Microscopically, the resection contained predominantly smooth muscle tissue with scattered small foci of glandular teratoma and CTT. Immunohistochemistry (SALL4, glypican 3) revealed no residual yolk sac tumor. Fluorescence in situ hybridization revealed gain of chromosome 12p. The patient has been disease-free for 13 years. This report expands the spectrum of primary central nervous system germ cell tumors with the occurrence of CTT in this site.

Combination cisplatin, vinblastine, and bleomycin chemotherapy (PVB) for malignant germ-cell tumors of the ovary.

1983 ◽  
Vol 1 (10) ◽  
pp. 645-651 ◽  
Author(s):  
R W Carlson ◽  
B I Sikic ◽  
M M Turbow ◽  
S C Ballon
Keyword(s):  
Germ Cell ◽  
Recurrent Disease ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Stage Iii ◽  
Treatment Toxicity ◽  
Malignant Germ Cell Tumors ◽  
Mixed Germ Cell Tumors

Nine women with germ-cell tumors of the ovary (three endodermal sinus tumors, four immature teratomas, and two mixed germ-cell tumors) were treated with cisplatin, vinblastine, and bleomycin (PVB) chemotherapy after cytoreductive operations. Five patients were stage I, three were stage III, and one patient had recurrent disease. All nine women are alive and without evidence of disease with a median follow-up of 31 months from diagnosis and 27 months since completion of PVB. Treatment toxicity although occasionally severe was rapidly reversible.

scholarly journals Are omentectomy and lymphadenectomy necessary in patients with apparently early-stage malignant ovarian germ cell tumors?

2019 ◽  
Vol 29 (2) ◽  
pp. 398-403 ◽  
Author(s):  
Beijiao Qin ◽  
Wenyan Xu ◽  
Yanfang Li
Keyword(s):  
Prognostic Factors ◽  
Germ Cell ◽  
Early Stage ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Yolk Sac ◽  
Immature Teratoma ◽  
Yolk Sac Tumor ◽  
Cancer Center ◽  
Early Stage Disease

ObjectiveTo evaluate the role of omentectomy and lymphadenectomy in the treatment of clinically apparent early-stage malignant ovarian germ cell tumors.MethodsWe retrospectively reviewed 245 patients with malignant ovarian germ cell tumors (yolk sac tumor, dysgerminoma, and immature teratoma) and with clinically early-stage disease, who were treated at Sun Yat-sen University Cancer Center between January 1, 1970 and December 31, 2017. The survival of patients who underwent either omentectomy or lymphadenectomy, or both (omentectomy/lymphadenectomy group) was compared with that of patients who did not undergo omentectomy or lymphadenectomy (non-omentectomy/lymphadenectomy group).ResultsSixty patients were diagnosed with yolk sac tumor, 74 with dysgerminoma, and 111 with immature teratoma. Of these 245 patients, 216 patients had stage I disease, 28 patients had stage II, and 1 patient had stage IIIA. There were 190 patients who underwent omentectomy and/or lymphadenectomy and 55 patients in the non-omentectomy/lymphadenectomy group, respectively. In the omentectomy/lymphadenectomy group, 112 patients underwent both omentectomy and lymphadenectomy, 71 underwent omentectomy only, and 7 underwent lymphadenectomy only. Two hundred and fourteen of 245 patients (87.3%) received post-operative chemotherapy. Median follow-up was 73 months (range 1–388). The 10-year overall survival rates in the omentectomy/lymphadenectomy group and non-omentectomy/lymphadenectomy groups were 96.8% and 100%, respectively (p=0.340). Multivariate analysis evaluating all potential prognostic factors showed that omentectomy and lymphadenectomy are not prognostic factors for survival.ConclusionsOmentectomy and lymphadenectomy do not appear to improve survival and may be omitted in patients with clinically apparent early-stage malignant ovarian germ cell tumors.

Prognostic Impact of Laterality in Malignant Ovarian Germ Cell Tumors

2011 ◽  
Vol 21 (2) ◽  
pp. 257-262 ◽  
Author(s):  
Haider Mahdi ◽  
Sanjeev Kumar ◽  
Shelly Seward ◽  
Assaad Semaan ◽  
Ramesh Batchu ◽  
...  
Keyword(s):  
Germ Cell ◽  
Proportional Hazards ◽  
Germ Cell Tumors ◽  
Cox Proportional Hazards ◽  
Prognostic Impact ◽  
Advanced Stage ◽  
Kaplan Meier ◽  
Stage Disease ◽  
Histologic Types ◽  
Mixed Germ Cell Tumors

Objective:To compare the survival of patients with bilateral versus unilateral malignant ovarian germ cell tumors (OGCT).Methods:Patients with a diagnosis of OGCT were identified from the Surveillance, Epidemiology, and End Results Program for the period 1988 to 2006 and were divided into bilateral and unilateral subgroups. Only surgically treated patients were included. Histologic types were grouped into dysgerminoma, malignant teratoma, and mixed germ cell tumors with pure nondysgerminoma cell tumors. Statistical analysis using Wilcoxon rank sum test, Kaplan-Meier survival methods, and Cox proportional hazards regression model were performed.Results:In 1529 patients with OGCT, 1463 (95.7%) were unilateral and 66 (4.3%) were bilateral. Bilaterality was more common with dysgerminomas (6.5%) and mixed germ cell tumors with pure nondysgerminoma cell tumors (6.25%) than with immature teratomas (1.7%),P< 0.001. Most OGCT (67.3%) were stage I. Bilateral OGCT were more likely than unilateral tumors to be associated with advanced-stage disease (FIGO III and IV, 41% vs 20%,P< 0.04). Overall 5-year survival was 93.6% for unilateral OGCT and 80.7% in bilateral OGCT,P< 0.001. In multivariate analysis, bilaterality was not an independent predictor of survival when controlling for age, histology, stage, and surgical staging (hazard ratio, 1.3; 95% confidence interval, 0.7-2.5;P= 0.40).Conclusions:Compared with unilateral tumors, bilateral OGCT are more often associated with advanced-stage disease, high-risk histology, and poor survival. When other prognostic factors are accounted for, bilaterality was not an independent prognostic predictor of survival.

scholarly journals Simultaneous intracranial and testicular germ cell tumors: illustrative case

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Lei Han ◽  
Jie Lu ◽  
Luxiong Fang ◽  
Songtao Qi ◽  
Ye Song
Keyword(s):  
Germ Cell ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Cystic Teratoma ◽  
Pineal Region ◽  
Illustrative Case ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
First Case

BACKGROUNDSimultaneous intracranial and testicular germ cell tumors (GCTs) are extremely rare, leading to a lack of adequate experience in their treatment. Therefore, the authors report a case of this kind of GCT.OBSERVATIONSA 5-year-old boy was admitted to the hospital with headache and vomiting. Computed tomography and magnetic resonance imaging suggested the possibility of a GCT in the pineal region. The value of the serum tumor marker alpha-fetoprotein (AFP) was 5,396.1 μg/L, and β-human chorionic gonadotropin levels were within the normal range. Subsequently, the tumor was removed, and the final pathological result was a mixed GCT. Therefore, chemotherapy and radiation were added. However, the authors found a testicular tumor on ultrasound at the same time, and pathology after surgery suggested a mature cystic teratoma. Following treatment, the patient recovered well, and AFP levels dropped to normal values.LESSONSTo the authors’ knowledge, this report is the fourth case of simultaneous intracranial and testicular GCTs and the first case of a simultaneous mixed GCT in the pineal region and mature teratoma of the testis. A combination of surgery, chemotherapy, and radiation therapy for mixed GCTs in the pineal region and surgical excision for testicular reproductive cell tumors are effective in these patients, but long-term monitoring is required.

scholarly journals Rare presentation of a seminoma with mixed germ cell tumor in undescended inguinal testis

2019 ◽  
Vol 6 (2) ◽  
pp. 611
Author(s):  
Siddhartha Verma ◽  
Heeralal Jakhar
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Cell Tumor ◽  
Uneventful Recovery ◽  
Predisposing Factor ◽  
Rare Presentation ◽  
Testicular Germ Cell ◽  
Mixed Germ Cell Tumor

Cryptorchidism is the most common predisposing factor in the development of testicular germ cell tumors. Seminoma is the most common malignancy developing in a cryptorchid testis. A rare case of seminoma with mixed germ cell tumor in an undescended testis is reported here. A 35-year-old male patient presented with swelling in left inguinal region science 1.5year. This  was smooth, firm to hard in consistency, restricted mobility and his left scrotum was empty. Serological markers α-FP, β-HCG, LDH were raised.  Sonography and CT scan revealed a testicular tumor in undescended left inguinal testis. High inguinal orchidectomy was done. Patient had an uneventful recovery. The histopathology report of biopsy revealed a seminoma with mixed germ cell tumor. Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. Therapy should begin between six months and two years of age and may consist of hormone or surgical treatment.

scholarly journals Testicular Germ Cell Tumors: Serological and Immunohistochemical Diagnosis

2021 ◽  
Vol 50 (1) ◽  
pp. 58
Author(s):  
Ivan Damjanov
Keyword(s):  
Germ Cell ◽  
Tumor Markers ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Published Data ◽  
Routine Practice ◽  
Testicular Germ Cell Tumors ◽  
Testicular Tumors ◽  
Testicular Germ Cell ◽  
Immunohistochemical Markers

<p>This review deals with serologic and immunohistochemical tumor markers used in clinical laboratories for the diagnosis of testicular germ cell tumors. Time tested serologic markers such as alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase are routinely used in the work-up of patients with testicular tumors. Professional organizations regulating the practice of medicine in most countries worldwide require that the laboratory values for these serologic reactants be included in the pathology reports on testicular tumors as part of the tumor staging process. Immunohistochemical markers of testicular germ have been identified and widely tested during the first two decades of the XXI century. We have selected the most useful immunohistochemical markers from a few of these markers and discussed them in this review.</p><p><strong>Conclusion</strong>. Published data show that testicular tumor markers are widely used in routine practice. The study of tumor markers has improved the pathologic and clinical diagnosis of testicular germ cell tumors and has thus contributed to their treatment.</p>

scholarly journals Unusual Cases of Pure Malignant Germ Cell Tumors of the Ovary: A Case Series on 10 Years Experience at a Tertiary Care Center

2021 ◽  
Author(s):  
Lajya Devi Goyal ◽  
Balpreet Kaur ◽  
Gitanjali Goyal ◽  
Parveen Rajora
Keyword(s):  
Germ Cell ◽  
Care Center ◽  
Tertiary Care ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Case Series ◽  
Immature Teratoma ◽  
Surgical Removal ◽  
Fertility Sparing ◽  
Bep Chemotherapy

Background: Malignant ovarian germ cell tumors (MOGCTs) are rare female cancers, constituting  up to 10% of ovarian cancers. Dysgerminoma is the most common histological variant. Surgical removal of the tumor with optimal debulking is the treatment of choice. Multidrug chemotherapy following surgery offers high remission rates. Considering the prevalence of these tumors in adolescent and young females, fertility-sparing treatment is of paramount importance. Methods: The data of all patients with ovarian malignancy admitted at a tertiary-care-teaching hospital from September 2009-March 2019 were analyzed. Ten patients of MOGCTs were treated in this period. The clinical features, radiological and biochemical findings, and management and treatment outcome were evaluated. Results: The median age of patients was 23 years. Histological subtypes included immature teratoma (n=3), endodermal sinus tumor (n=4), and dysgerminoma (n=3). Tumor markers namely AFP, βHCG, and LDH increased in all except the patients with immature teratoma. Two patients with dysgerminoma were in the second trimester of pregnancy. All patients except one underwent surgery followed by BEP chemotherapy. Two patients had developed metastasis within six months of treatment and died. In seven patients, no evidence of disease was reported till date. Conclusion: Management of antenatal patients with dysgerminoma by surgery followed by BEP chemotherapy has favorable prognosis. Fertility-sparing surgery with adjuvant chemotherapy offers great advantage in young girls. However, risk stratification based on prognostic factors should be implemented in order to individualize the treatment for achieving higher survival rates. The option for oocyte-cryopreser-vation prior to surgery must be discussed with patients desiring future fertlity.

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