Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration

Hayati, Firdaus; Ali, Nurayub Mohd; Belani, Levin Kesu; Azizan, Nornazirah; Zakaria, Andee Dzulkarnaen; Rahman, Mohd Ramzisham Abdul

doi:10.1155/2016/7615029

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…Hayati et al performed a piecemeal resection of 3.5 kg of GCT in a 16-year-old male through a posterolateral thoracotomy. In this case, only a teratomatous component of the tumor was found in the final pathology [6]. Fritzcshe et al removed a 3-kg GCT via a right pneumonectomy, revealing a mixture of an immature teratoma on final pathology [7].…”

Section: Discussionmentioning

confidence: 83%

Resection of a Large Growing Mediastinal Germ Cell Tumor Using a Multidisciplinary Approach

Greene,

Wood,

Champion

et al. 2023

Current Oncology

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Mediastinal germ cell tumors (GCTs) are rare. Post-chemotherapy residual masses in patients with a nonseminomatous GCT require resection. A patient with a large mediastinal GCT involving the left subclavian artery, superior vena cava (SVC) and hilum of the right lung is presented. Despite a biochemical response to chemotherapy, the tumor enlarged on serial imaging. With guidance from medical oncology, a multidisciplinary surgical team, including cardiac anesthesia, cardiac surgery and thoracic surgery resected the tumor with a staged reconstruction of the SVC. The procedure was well tolerated and yielded clear margins. The final pathology showed a significant associated component of rhabdomyosarcoma.

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Section: Discussionmentioning

confidence: 83%

Resection of a Large Growing Mediastinal Germ Cell Tumor Using a Multidisciplinary Approach

Greene,

Wood,

Champion

et al. 2023

Current Oncology

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“…Most cases of giant mediastinal GCTs have been reported in an older age group probably due to a comparatively larger chest cavity; the tumor may grow up to greater sizes before the symptoms become evident. [4,15] This study highlights the successful management of 12 such pediatric cases.…”

Section: Discussionmentioning

confidence: 84%

Management and Long-term Outcomes of Giant Mediastinal Germ Cell Tumors in Children

Khanna

Agarwala

Bishoi

et al. 2019

Indian Journal of Medical and Paediatric Oncology

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Purpose: The purpose of the study is to evaluate the outcome of children with giant mediastinal germ cell tumors (GCTs). Materials and Methods: A retrospective study of children diagnosed with GCTs treated at our hospital from 1998 to 2014 was performed. They were evaluated for their tumor size, malignancy, treatment, complications, and outcome. Results: Twelve giant mediastinal GCT patients were included in the study. Age ranged from 7 to 144 months (median 12 months) and all except one were males. The average tumor size was 10.4 cm (range 6 cm × 5 cm–16 cm × 13 cm) and in four patients, they were large enough to occupy nearly the entire hemithorax. Nine children had benign tumors, and these were resected upfront. The remaining three cases with malignant disease received neoadjuvant chemotherapy. No significant reduction in size was noticed in these patients, but alpha-fetoprotein levels decreased in all the three, and they were later resected. Eight (67%) were resected through posterolateral thoracotomy and 4 (33%) through median sternotomy approach. One patient had a dumbbell-shaped thoracoabdominal tumor extending through a Bochdalek hernia. He required additional laparotomy as well as diaphragmatic repair. There were no postoperative complications. The malignant GCTs received total four courses of PEB. All patients were alive and asymptomatic at a mean follow-up of 55.4 months (range 10–146 months). Conclusions: Mediastinal GCTs have bimodal age distribution and show male preponderance. Malignant mediastinal GCTs responded well to neoadjuvant chemotherapy through a reduction in size was not noticed. Complete excision often in coordination with cardiothoracic-vascular surgeons can lead to long-term symptom-free survival even in giant tumors.

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“…A few cases of EGGCT with the initial manifestation of pericardial effusion (20,8,12,10,16) responded well to chemotherapy and surgical resection.…”

Section: Discussionmentioning

confidence: 99%

A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade

et al. 2021

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The clinical manifestations of extragonadal germ cell tumor (EGGCT) depend on its location and are often caused by compression on surrounding structures. Pericardial effusion is absolutely rare as an initial clinical manifestation for this tumor. We report a 31-year-old man presenting to the emergency department with dyspnea. Two-dimensional echocardiography revealed a massive pericardial effusion with impending tamponade. The patient was immediately transferred to the operating room where a cardiac surgeon drained bloody effusion. A mediastinal mass measuring 173×105×105 mm was accidentally noticed during COVID-19 work-up. Fine core needle biopsy of the mass led to the diagnosis of a germ cell tumor, which was treated appropriately. This study shows the importance of proper work-up in pericardial effusion cases with chest CT-scan as an important part of it.

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Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration

Cited by 6 publications

References 14 publications

Resection of a Large Growing Mediastinal Germ Cell Tumor Using a Multidisciplinary Approach

Resection of a Large Growing Mediastinal Germ Cell Tumor Using a Multidisciplinary Approach

Management and Long-term Outcomes of Giant Mediastinal Germ Cell Tumors in Children

A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade

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