Mediastinal germ cell tumors and development of secondary leukemia and solid tumors.

Madden, N.A.; Rabatic, B.M.; Zaenger, D.; Marascio, J.A.; Marchan, Edward M.; Dasher, B.G.; Martin, William; Howington, J.; Aletan, M.; Stewart, John; Pishgou, M.; Amoush, A.; Ferguson, C.L.; Kong, Feng-Ming; Mourad, W.F.

doi:10.1200/jco.2016.34.15_suppl.e16043

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“…Number in brackets indicates the number of cases with data on each feature. References for case reports included in table [7,8,17,[19][20][21][22][23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

“…The rare association of hematologic neoplasia and extragonadal germ cell tumors appears to be exclusive to mediastinal non seminomatous GCT with an incidence of 2% in this patient group in one case series of 287 patients [ 8 ]. The spectrum of hematologic disease in this setting is unusual, with a predominance of clonal megakaryocytic disorders (AML M7 [French–American–British classification] and MDS with abnormal megakaryocytes) but also mast cell and undifferentiated leukemias (Table 1 [ 7 , 8 , 17 , 19 – 30 ]). Both lymphoblastic and acute erythroid leukemia have been described after or concurrent to GCT but to our knowledge this is the first case where three different sequential hematological malignancies of different lineages have been demonstrated (MDS, ALL and erythroleukemia).…”

Section: Discussionmentioning

confidence: 99%

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Three distinct hematological malignancies from a single germ cell tumor: a case report

et al. 2020

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Background The association between non seminomatous germ cell tumors (GCTs) and hematological malignancies of rare lineage has been described in the literature. In some of these cases there is evidence that the leukemia derives from a pluripotent primitive clone present in the original germ cell tumor. Case presentation We present a highly unusual case of a 23-year-old man of South Asian origin with a history of Klinefelter’s syndrome who initially developed mediastinal non seminomatous GCT. Following treatment with surgery and standard chemotherapy he went on to develop three different hematological malignancies of distinct lineages in sequential fashion over a short time period. Despite treatment with multiple intensive chemotherapy regimens and a matched unrelated donor allogeneic stem cell transplant, he died 41 months after initial diagnosis of his GCT and 10 months after the first diagnosis of hematological malignancy. Conclusions This is an extreme case that highlights the pluripotency and aggressiveness of these GCT-derived hematological malignancies, and the need for novel therapeutic approaches.

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“…Number in brackets indicates the number of cases with data on each feature. References for case reports included in table [7,8,17,[19][20][21][22][23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%