Postchemotherapy-related changes in mediastinal mixed germ cell tumor masquerading as a vascular neoplasm

Hui, Monalisa; Tandon, Ashwani; Uppin, Shantveer G; Paruchuri, Rakhee Kumar

doi:10.4103/0377-4929.107803

Cited by 4 publications

(5 citation statements)

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“…However, the atypia of the vasculoconnective component seemed to be unrelated to the patient's prognosis and might be on the spectrum of chemotherapy-induced changes, though survival analysis was not feasible due to the small number of patients and short follow-up period of the current study. Together with our recent case described above and previous studies ( 21 23 24 ), it is suspected that the vasculoconnective component may exist in mediastinal mixed GCTs as an intrinsic component rather than a postchemotherapy-related change.…”

Section: Discussionsupporting

confidence: 76%

“…In the current study, we postulated that the vasculoconnective component in previous studies ( 23 24 ) and the current study would be the intrinsic component of primary mediastinal mixed GCT. These vasculoconnective components are different from sarcomatous components, because they are intermingled with residual teratoma, rather than forming a mass-like lesion or infiltrate into the surrounding tissue.…”

Section: Discussionmentioning

confidence: 61%

“…Thus far, only two cases of vascular elements in mediastinal mixed GCTs have been reported ( 23 24 ). Hui et al ( 24 ) described a mediastinal mixed GCT in a 14-yr-old boy, which was predominantly composed of vasculoconnective elements mimicking a hemangioma and a mature teratoma in the resected specimen after chemotherapy. They concluded that the vasculoconnective tissue might be a result of postchemotherapeutic changes.…”

Section: Discussionmentioning

confidence: 99%

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Exuberant Vasculoconnective Component in Mediastinal Mixed Germ Cell Tumors

et al. 2015

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We aimed to evaluate the histologic components of primary mediastinal mixed germ cell tumors. A total of 221 patients diagnosed with a mediastinal germ cell tumor (GCT) were retrospectively reviewed. Among them, 14 patients underwent surgical resection after chemotherapy and 8 patients were diagnosed with mixed GCT, who were then selected for further evaluation. Clinical chart review and histologic review of biopsy and surgical specimens of 8 patients were performed. All 8 patients were young males and showed a mature teratoma or a mature teratoma with a focal immature teratoma in the resected specimens. Serum alpha-feto protein was variably elevated. Seven patients experienced an increase in tumor size after the chemotherapy. In 5 patients, a variable amount of vasculoconnective tissue was found along with the mature teratoma occupying average 66.3% of resected mass, and 3 of them showed an identical vasculoconnective component on biopsy before chemotherapy. We suggest that vasculoconnective tissue might be the intrinsic component of primary mediastinal mixed GCT. When vasculoconnective tissue is obtained on small biopsy of an anterior mediastinal mass of a young male, the possibility of underlying mixed GCT should be considered and further clinical work up should be performed.Graphical Abstract

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Exuberant Vasculoconnective Component in Mediastinal Mixed Germ Cell Tumors

et al. 2015

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“…Their cases of 55 patients were associated with yolk sac tumour components, and all specimens were analyzed after chemotherapy. A few similar cases have been published previously, associated with PMTERs independent of prior chemotherapy 142–145 . Recently, a case report also showed a VMT combined with a PMSEMs without prior chemotherapy 146 .…”

Section: Pmgcts With Somatic‐type Solid Malignanciesmentioning

confidence: 65%

“…A few similar cases have been published previously, associated with PMTERs independent of prior chemotherapy. [142][143][144][145] Recently, a case report also showed a VMT combined with a PMSEMs without prior chemotherapy. 146 VMT consists of neoplastic vascular and stromal components that show different grades of atypia in both components (low-and high-grade VMT).…”

Section: Pmgcts With Somatic-type Solid Malignanciesmentioning

confidence: 99%

Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges

Fichtner,

Marx,

Ströbel

et al. 2023

Histopathology

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This article will review current aspects of the histopathological, immunohistochemical and molecular analysis of primary mediastinal germ cell tumours (PMGCTs) as well as their aetiological, epidemiological, clinical and therapeutic features. PMGCTs represent an important differential diagnosis in the spectrum of mediastinal tumours, and their diagnosis is usually made on small tissue samples from core needle biopsies in combination with diagnostic imaging and serum tumour markers. As in lymphomas, a small biopsy is often the only viable tumour sample available from these patients, as they receive chemotherapy prior to eventual surgical resection. Pathologists therefore need to apply an efficient combination of immunohistochemical markers to confirm the diagnosis of a PMGCT and to exclude morphological mimics.

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Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review

Zhanxian¹,

Han²,

Jinzhi³

et al. 2023

Diagn Pathol

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Germ cell tumours with somatic-type solid malignancy (GCT-STM) are a rare disease of the mediastinum. Recently, a cohort of vasculogenic mesenchymal tumour (VMT)-nonseminoma cases with different prognoses were recognized and reported. Here, we report a case of mediastinal high-grade VMT with a seminoma. A 16-year-old male had a fever, chest tightness and fatigue. Chest CT showed a 7.5 cm×5.3 cm solid mass in the right anterior mediastinum. The serum levels of alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-HCG) and carcinoembryonic antigen (CEA) were within the normal range. Tumorectomy was performed. The tumour was irregular, and no capsule was found. The cut surface was greyish white and greyish brown with medium consistency. There were foci of bleeding and necrosis. Microscopic histology showed prominent vascular proliferation, which was lined by mildly atypical endothelial cells in a cellular stroma with significant cytologic atypia. The vascular spectrum varied from crevice-like or antler-like thin- to thick-walled vessels. Beyond the tumour area, inside the remnant thymus tissues, there were small clusters of polygonal tumour cells with clear cytoplasm, distinct cell membranes, and round to polygonal nuclei with prominent nucleoli that were positive for Oct4, PLAP, SALL4 and CD117. The patient did not receive any treatments pre- or postoperation, and his condition was stable without progression after 14 months of follow-up evaluation. Here, we added a new entity of GCT-STM of the mediastinum composed of VMT and seminoma. A better understanding of the pathological features of GCT-VMT could help pathologists improve their awareness of these rare diseases.

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Postchemotherapy-related changes in mediastinal mixed germ cell tumor masquerading as a vascular neoplasm

Cited by 4 publications

References 0 publications

Exuberant Vasculoconnective Component in Mediastinal Mixed Germ Cell Tumors

Exuberant Vasculoconnective Component in Mediastinal Mixed Germ Cell Tumors

Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges

Mediastinal high-grade vasculogenic mesenchymal tumour with seminoma: a case report and literature review

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