Extragonadal mixed germ cell tumor of the right arm: description of the first case in the literature

Benali, H. Ait; Lalya, lssam; Allaoui, Mohamed; Benmansour, Aniss; Elkhanoussi, Basma; Benjelloun, S; Benjaafar, Noureddine; Elyaacoubi, Mourad

doi:10.1186/1477-7819-10-69

Cited by 15 publications

(19 citation statements)

References 21 publications

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“…Primary GCTs of extragonadal origin comprise 3% to 5% of all GCTs. They usually arise from midline structures but can also be found in three regions, such as the vulva, arm, and prostate [2,[18][19]. The histogenesis of extragonadal GCTs remains largely unknown.…”

Section: Discussionmentioning

confidence: 99%

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Mixed germ cell tumor of the endometrium: a case report and literature review

Zhang¹,

Liu²,

Wei

et al. 2020

Open Medicine

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AbstractGerm cell tumors (GCTs) localized extragonadally are rare, with only 14 reported cases of a yolk sac tumor in the endometrium. Here we report a case of mixed endometrium GCTs in a 65-year-old postmenopausal woman with abnormal vaginal bleeding. An ultrasound examination showed an oval-shaped mass in the patient’s uterine cavity. Biochemical examination revealed elevated serum α-fetoprotein (AFP) at 359 ng/mL, whereas the tumor markers CA-125, CA-199, and CEA were all within normal range. Total hysterectomy and bilateral salpingo-oophorectomy were performed;. a histological examination revealed that the malignant components contained a yolk sac tumor, embryonal carcinoma, and focal immature teratoma. Immunohistochemical staining showed that AFPs were diffusively distributed in both the yolk sac tumor and embryonal carcinoma. The stem cell marker OCT3/4 was positive in the embryonal carcinoma component and that the pan-cytokeratin AE1/AE3 staining was positive in glandular areas. GFAPs (Glial Fibrillary Acidic Proteins) were positive in neuroectodermal tubules; the Ki-67 protein was positive in 90% of the tumor cells, whereas CD117 and placental alkaline phosphatase (PLAP) were negative. The cumulative evidence indicated mixed GCTs of endometrium as the final histopathological diagnosis. The patient received three courses of adjunct chemotherapy that provided good therapeutic efficacy as evidenced by the decreased serum AFP level. Our report on this rare case of mixed GCTs of the endometrium, supported by associated histological patterns and immunophenotypes and successful adjunct chemotherapy after surgery, could provide insight on future treatment of this rare but lethal disease.

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Section: Discussionmentioning

confidence: 99%

“…They frequently occur in the gonads (ovary or testes) of young people. Some GCTs are classified as extragonadal if there is no presence of primary tumors in either the testes or ovaries [2]. GCTs typically arise in midline locations along which the primitive germ cells migrate from the wall of the yolk sac to the gonadal ridge.…”

Section: Introductionmentioning

confidence: 99%

Mixed germ cell tumor of the endometrium: a case report and literature review

Zhang¹,

Liu²,

Wei

et al. 2020

Open Medicine

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“…We also found descriptions of four cases of GCTs arising outside of the midline, without evidence of a primary tumor; the authors considered these GCTs to be primary tumors [ 8 – 11 ]. One of these reports describes a malignant mixed GCT in the soft tissue of the right arm of a 37-year-old man, with no other sites of involvement; in this case, immunochesmistry was not performed, and serum markers for GCT were within normal limits [ 8 ]. Another report describes the case of a malignant teratoma in the left proximal humerus of a 14-year-old girl.…”

Section: Discussionmentioning

confidence: 99%

“…Only two cases of primary testicular teratomas that metastasized to soft tissue (the left thigh and gluteal and iliac muscles, respectively) have been reported in the literature [ 6 , 7 ]. In addition, the literature contains only four descriptions of GCTs arising primarily from structures away from the midline [ 8 – 11 ]. Here we present the first reported case of an immature teratoma manifesting as a subcutaneous mass in the thigh, with no evidence of other sites of involvement, except the lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Immature teratoma presenting as a soft-tissue mass with no evidence of other sites of involvement: a case report

et al. 2016

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BackgroundGerm cell tumors are tumors composed of tissues derived from more than one of the three germinal layers. They are more common in the testes and ovaries, but can present in many different regions in the midline, including the sacral region, retroperitoneum, mediastinum, and brain. Testicular germ cell tumors generally metastasize to the retroperitoneum, lungs, and brain; metastases to soft tissue are very rare.Case presentationHere we describe a case of a single soft-tissue mass in the thigh of a 27-year-old man, with histology showing areas of mature teratoma tissues derived from the ectodermal and mesodermal lineages, and areas of immature teratoma tissue composed of small undifferentiated cells, with primitive neuroectodermal differentiation foci forming neuroepithelial elements – thus classified as immature teratoma. The patient had no other clinical or radiological evidence of involvement, besides the lymph nodes.ConclusionThe case presented suggests a rare and unexpected primary immature teratoma of the thigh.

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“…They typically occur in males between the ages of 20-30 years [2] . Germ cell tumors much more commonly arise in gonadal tissues (ovaries or testes) while extragonadal germ cell tumors are hypothesized to originate from germ cells that do not undergo normal migration along the urogenital ridge or that undergo reverse migration [2,5,10] . The most common site for extragonadal germ cell tumors is the anterior mediastinum, which can cause cough, chest pain, shortness of breath, fever, and weight loss [1][2][3][4][5] .…”

Section: Discussionmentioning

confidence: 99%

Extragonadal yolk sac tumor (endodermal sinus tumor) presenting with biliary tract obstruction in a woman

Topoll

Wilfong

O'Dell

et al. 2015

CRIM

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A 35-year-old woman presented to her primary care physician with early satiety, weight loss, nausea, vomiting, and pruritus. She was eventually found to have a pancreatic mass obstructing the bile duct. The mass was evaluated by endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) with biopsy. Histopathology results revealed a high grade malignant neoplasm of uncertain type. The tumor was further characterized by open biopsy, which revealed a yolk sac tumor (endodermal sinus tumor). Her disease was unresectable. Serum alpha-fetoprotein (AFP) levels were markedly elevated (693.3 ng/ml; reference range: 0-8 ng/ml). The patient was treated with bleomycin, etoposide, and cisplatin (BEP) with a partial response and a persistently elevated serum AFP of 139.7 ng/ml. She then received salvage chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP), with a minimal response (serum AFP, 68 ng/ml). She next received an autologous bone marrow transplant, with a decline in AFP to 19 ng/ml after the first of two tandem transplants. This case report illustrates a rare presentation of an extragonadal endodermal sinus tumor in a woman with biliary tract obstruction as the predominant manifestation.

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Extragonadal mixed germ cell tumor of the right arm: description of the first case in the literature

Cited by 15 publications

References 21 publications

Mixed germ cell tumor of the endometrium: a case report and literature review

Mixed germ cell tumor of the endometrium: a case report and literature review

Immature teratoma presenting as a soft-tissue mass with no evidence of other sites of involvement: a case report

Extragonadal yolk sac tumor (endodermal sinus tumor) presenting with biliary tract obstruction in a woman

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