Germ cell tumors (GCT) comprise roughly 14% of malignancies in adolescents, with about 5% of these localizing to the anterior mediastinum. 1,2 In general, pediatric GCT have survival rates higher than 90%. 2 This survival rate dramatically decreases with a coinciding hematologic malignancy. Primary mediastinal GCT (PMGCT) has a well-established association with hematologic malignancies,