scholarly journals Extragonadal Germ Cell Tumors in Children and Adolescents - a 20 Year Study

2020 ◽  
Vol 27 (4) ◽  
pp. 281-287
Author(s):  
Felice FAIZAL ◽  
Alka KALGUTKAR ◽  
Vandana DAHAKE

Germ cell tumors (GCT) are rare neoplasms which are seen in all age groups and both sexes. Gcts in the pediatric age group show considerable variation from their adult counterparts in relation to site, histological type, clinical and radiological features and response to treatment. Extragonadal gcts are much more common in the pediatric age group with the most common sites being sacrococcygeal region, head and neck, retroperitoneum and mediastinum. Unusual sites like the vagina and urinary bladder have also been reported. Therefore, the varied presentations and different treatment options should be considered.

2020 ◽  
Vol 8 (4) ◽  
pp. 57
Author(s):  
Rajendra Kumar Tanwar ◽  
Bharti Saxena ◽  
Shankar Lal Mohanpuria ◽  
Harsh Goyal ◽  
Laxmi Agarwal ◽  
...  

Author(s):  
Kimberley Bonouvrie ◽  
Jutte van der Werff ten Bosch ◽  
Machiel van den Akker

Abstract Objective The most common presentation of Klinefelter syndrome (KS) is infertility and features of hypogonadism. Currently no consensus exists on the risk of malignancy in this syndrome. Several case reports show an incidence of extragonadal germ cells tumors (eGCT) of 1.5 per 1000 KS patients (OR 50 against healthy population). Malignant germ cell tumors are rare in children. They account for 3% of all children cancers. Young patients with a germ cell tumor are not routinely tested for Klinefelter syndrome. This can therefore result in underdiagnosing. Literature data suggest a correlation between eGCT and KS. To the best of our knowledge there is no precise description of the primary locations of germ cell tumors in KS patients. The purpose of this study is to evaluate age groups and primary locations of extragonadal germ cell tumors in Klinefelter patients. With this data we investigate whether it is necessary to perform a cytogenetic analysis for KS in every eGCT patient. Study design This study is based on case report publications in PubMed/Medline published until march 2020 that described “Klinefelter Syndrome (MeSH) AND/OR extragonadal germ cell tumors”. Publications were included when patients age, location and histology of the germ cell tumor was known. Two double blinded reviewers selected the studies.Results: 141 KS patients with eGCTs were identified. Mean age at presentation was 17.3 years (StDev + − 10.2). In contrast to the extragonadal germ cell tumors in adults, most eGCT in children were mediastinal or in the central nervous system (respectively 90/141; 64% and 23/141; 16% of all tumors). Distribution of histologic subtypes showed that the largest fraction represented a teratoma, mixed-type-non-seminomateus GCT and germinoma, respectively 34/141; 24%, 26/141; 18% and 20/141; 14% of all tumors. Conclusion These data suggest a correlation between primary extragonadal germ cell tumors and Klinefelter syndrome. There appears to be an indication for screening on KS in young patients with an eGCT in the mediastinum. A low threshold for radiologic examinations should be considered to discover eGCT. We emphasize the need for genetic analysis in all cases of a male with a mediastinal germ cell tumor for the underdiagnosed Klinefelter syndrome.


1980 ◽  
Vol 08 (01n02) ◽  
pp. 26-36 ◽  
Author(s):  
Suzanne Chan Ho ◽  
Kwok Chan Lun ◽  
W. K. Cheng Hin Ng

A retrospective study of 672 sampled records of patients of a major institutions providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for ''infective'' and ''internal, emotional and weakness'' diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.


Author(s):  
Madhusmita Choudhury ◽  
Monoj K. Deka ◽  
Shah A. Sheikh

Background: Ovarian malignancy is the second most common cancer of the female reproductive system and the leading cause of death from gynecologic malignancy. With increase in longevity, the incidence of epithelial ovarian cancer is increasing and its etiopathology remains unknown. A female’s risk at birth of having ovarian tumour sometime in her life is 6-7%. Two third of ovarian tumours occur in women of reproductive age group. The aim was to study the distribution of morphological pattern of benign, malignant, and nonneoplastic lesions of the ovary in different age groups and to determine the likelihood of bilateral involvement in different morphologic subtypes.Methods: A retrospective study from January 2018 to December 2020 was undertaken. A total of 210 surgical specimens were obtained. Detailed clinical information and radiological findings were recorded from the case sheets. Grossing of the surgical specimens was done in the pathology department, followed by histological examination.Results: Of 210 cases, benign cases were 140 (66.7%), malignant cases were 70 (33.3%). Surface epithelial tumors were most common (116/55.2%) followed by germ cell tumors (76, 36.1%) followed by others. Serous cystadenoma was commonest benign tumor (58, 41.4%). Serous adenocarinoma was commonest malignant tumor (19, 27.1%). Benign tumours were more common in the younger age group i.e. <40 years of age whereas malignant tumours were supervenes with increase in age. Most benign ovarian tumors (54, 38.6%) were seen between 31-40 years whereas most malignant tumors (24, 34.3%) were seen above 40 years. In 1st two decades, germ cell tumors were more common than other tumours.Conclusions: The prognosis and varying therapeutic strategies of ovarian tumours necessitate an accurate pathological evaluation. Histopathological study is still the gold standard in diagnosing most of these tumours. 


2019 ◽  
Vol 15 (1) ◽  
pp. 22-29
Author(s):  
Binita Goyal ◽  
T Sheshagiri Rao ◽  
Himanshu Regmi

Background: Ovarian tumors are histogenetically varied and complex tumors spanning all age groups. They account for 30% of all gynaecologic cancers. Malignant tumors carry a high mortality due to its late detection and ineffective screening programs. Current study aims at finding association between age at presentation and size of tumor with behavior of tumors and also association between category of tumor and age at presentation. Methods: This Hospital record based cross-sectional (historical) study was carried out on 158 cases of ovarian tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of five and a half years from January 2012 to June 2017. Results: Age of the patients ranged from 12 to 88 years with maximum cases 96 (60.8%) in 20 – 40 years age group. The mean ±SD of age was 36.6±14.4 years. Majority of the cases 137 (86.7%) were benign. Sixteen (10.1%) cases were malignant and 5 (3.2%) cases were borderline. Majority of both benign and malignant cases were seen in 20 – 40 years age group. Size of the tumors ranged from 2 – 30 cm with mean±SD of 9.9±5.0 cm and maximum 93 (58.9%) cases in the size range of 5 – 10 cm. Majority of both benign and malignant tumors were in the size range of 5 – 10 cm. There was no association of age at presentation and size of tumor with behavior of tumor (p > 0.05). Sevety five (47.5%) cases were germ cell tumors, 72 (45.6%) cases were surface epithelial-stromal tumors, 9 (5.7%) cases were sex cord-stromal tumors, 1 (0.6%) was bilateral with surface epithelial tumor in right ovary and germ cell tumor in left ovary and 1 (0.6%) case was soft tissue tumor not specific to ovary. Majority of cases of germ cell tumors were seen below 40 years age whereas significant proportion of surface epithelial-stromal tumors was seen after 40 years with significant association between category and age at presentation (p < 0.05). Most common histopathological diagnosis overall was dermoid cyst in 43.7% cases. Conclusions: Benign ovarian tumors were more common than  malignant ones. Malignancy was seen in all age groups and in any size tumor. Surface epithelial-stromal   tumors and germ cell tumors were roughly equal in frequency with slight predominance of latter. Germ cell tumors were common in younger whereas surface epithelial-stromal tumors were more common in older   individuals. Histopathological examination in any ovarian tumor at any age with any size is mandatory.


2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Fiaz Alam ◽  
Mohammed Hammoudeh

Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is an autoinflammatory disease manifested as recurrent febrile episodes associated with one of the following cardinal features: aphthous ulceration, pharyngitis, and cervical adenitis. It was initially described in children and thought to be a disease of pediatric age group. Few adult cases were also reported in the literature. We describe the case of a 39-year-old female affected by PFAPA who presented with a history of febrile episodes associated with aphthous ulceration, stomatitis, and tonsillitis for 4 years. The febrile episodes occurred at a regular interval of 4 weeks and resolved within 5 days. The patient underwent tonsillectomy without any significant improvement. The patient responded only to a single high dose of steroid during the attack. Although PFAPA was initially thought to be a disease of pediatric age group, it should be considered in patients with recurrent febrile illness in all age groups.


2018 ◽  
Vol 15 (02/03) ◽  
pp. 087-093
Author(s):  
Swarup Sohan Gandhi ◽  
Manish Mann ◽  
Shashikant Jain ◽  
Ugan Singh Meena ◽  
Virendra Deo Sinha

Abstract Background and Aim of Study Coagulopathy is a common occurrence following traumatic brain injury (TBI). Various studies have reported the incidence and risk factors of coagulopathy and their correlation with poor outcome in adult as well as pediatric age group. In our study, we aim to analyze trauma-induced coagulopathy in adult and pediatric patients. Methods Adult (> 18 years) and pediatric (< 18 years) patients of TBI admitted in the intensive care unit of a trauma center of a tertiary care center had been studied from August 2015 to March 2018. Patients were further subdivided into moderate and severe TBI based on Glasgow Coma Scale (GCS) of 9 to 12 and < 9, respectively. Coagulation profile (prothrombin time [PT], activated partial thromboplastin time [APTT], thrombin time, fibrinogen, and D-dimer) and arterial blood gas (ABG) analysis were done on day of admission and on days 3 and 7. Coagulation profiles were analyzed in both the age groups, and risk factors were studied and correlated with the mortality and morbidity based on the Glasgow outcome score. Results Two hundred patients including 143 adults and 57 pediatric patients were included. Mean age among the adult and pediatric population was 31.51 ± 16.83 and 11.5 ± 5.90 years, respectively. In adults, 96 (83.62%) out of 116 in severe TBI group and 20 (74.07%) out of 27 in moderate TBI group developed coagulopathy, and in pediatric age group, 14 (70%) out of 20 in moderate TBI and 30 (81.08%) out of 37 in severe TBI developed coagulopathy. Midline shift was significantly associated with coagulopathy in both the age groups (p value < 0.039). Mortality was not significantly different in patients with coagulopathy between the age groups, but improved status as per the Glasgow outcome score was more in pediatric age group. Conclusion The development of coagulopathy is a frequent complication in patients with moderate to severe TBI in both age groups. Even though it is not closely associated with death in this study, it may be regarded as a marker of injury severity.


2021 ◽  
Vol 27 (1) ◽  
pp. 63-71
Author(s):  
Maria Consiglia Trotta ◽  
Roberto Alfano ◽  
Giovanna Cuomo ◽  
Ciro Romano ◽  
Antonietta Gerarda Gravina ◽  
...  

OBJECTIVE To compare the timing of serum anti-drug antibodies in adult and pediatric age groups, males and females, treated for inflammatory bowel disease or arthritis with adalimumab or infliximab by retrospectively combining data collected during a 2-year therapeutic drug monitoring period. METHODS Four hundred thirty sera were divided in groups collected at 0, 3, 6, 12, and 24 months (T0, T3, T6, T12, and T24) after initiation of therapy and assayed for drug and relative anti-drug antibodies levels. At each time point, the percentage of sera presenting anti-drug antibodies, as well as the drug concentrations, were calculated and correlated with patient age and sex. RESULTS Anti-drug antibodies were present in 31.5% of sera and were significantly higher in the pediatric age group than in the adult age group, through all time points. The percentages of sera showing anti-drug antibodies were significantly different as early as 3 months and were sera from pediatric female group. The percentages of sera showing anti-drug antibodies reached the highest value at 6 months in the pediatric age group and at 12 months in the adult age group. CONCLUSIONS Sera from pediatric had an earlier presence of anti-drug antibodies than adults. In particular, pediatric females sera showed the fastest anti-drug antibodies development.


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