Secondary malignant transformation of testicular teratomas: Case series and literature review

García-Labastida, Laura Elvira; Gómez‐Macías, Gabriela Sofía; Flores‐Gutiérrez, Juan Pablo; Ponce-Camacho, Marco Antonio; Áncer‐Rodríguez, Jesús; Barboza-Quintana, Oralia; Garza‐Guajardo, Raquel

doi:10.1016/j.acuroe.2014.09.002

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…Somatic and leukemic malignant transformation of GCT can occur 28–34 . Although the possibility of somatic malignant transformation in an underlying completely effaced germ cell tumor cannot be definitively excluded in the patients presented here, our suspicion for this is very low given the lack of evidence of involvement of the classic GCT primary sites (gonadal and extragonadal) for either patient.…”

Section: Discussionmentioning

confidence: 70%

Pitfalls in the diagnosis of yolk sac tumor: Lessons from a clinical trial

Yang

Patterson

Pavlock

et al. 2021

Pediatric Blood & Cancer

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Though outcomes for patients with recurrent/refractory malignant germ cell tumors (mGCTs) are poor, therapies targeting mTOR and EGFR inhibition have shown promise in vitro. We hypothesized that the combination of sirolimus and erlotinib will show activity in patients with recurrent/refractory mGCTs. Patients were enrolled in a prospective phase II clinical trial; central review of existing pathology specimens was performed. Of the five patients evaluated, two had their diagnoses revised to pancreatic acinar cell carcinoma and alpha‐fetoprotein (AFP)‐secreting gastric adenocarcinoma, respectively. Although mGCTs are common AFP‐secreting neoplasms, recurrence or refractoriness to standard regimens should prompt histologic reevaluation for other diagnoses.

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Section: Discussionmentioning

confidence: 70%

Pitfalls in the diagnosis of yolk sac tumor: Lessons from a clinical trial

Yang

Patterson

Pavlock

et al. 2021

Pediatric Blood & Cancer

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“…Adjuvant chemotherapy is not recommended in testicular teratomas or pediatric teratomas of any stage because these tumors are considered chemoresistant. The risk of malignant somatic transformation is about 3%-6% in patients with testicular non-seminoma GCTs [55][56][57]. Most common are primitive neuroectodermal tumors (30.8%), followed by sarcoma (23.3%), mixed histologies (16.7%), and adenocarcinoma (15.7%) [55].…”

Section: Testicular Teratomasmentioning

confidence: 99%

Malignant ovarian and testicular germ cell tumors: Common characteristics but different prognoses

Sköld,

Jansson,

Glimelius

2024

J Intern Med

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Both ovarian and testicular germ cell tumors (GCTs) arise from the primordial germ cell and share many similarities. Both malignancies affect mainly young patients, show remarkable responsiveness to cisplatin‐based therapy, and have an excellent prognosis, which also highlights the importance of minimizing long‐term side effects. However, certain differences can be noted: The spreading of the disease differs, and the staging system and treatment recommendations are dissimilar. Moreover, the prognosis for ovarian GCTs is significantly inferior to that for testicular cancer, as exemplified in this review comparing the survival in Swedish patients diagnosed with testicular (1995–2022) and ovarian (1990–2018) GCTs. The 5‐year overall survival in ovarian GCTs was 85.2%, versus 98.2% for testicular GCTs. How can this be explained? One reason may be the difference in knowledge, experience, and evidence because the incidence rate of testicular cancer is more than 15 times that of ovarian GCTs. Given the rarity of the disease in women and the lack of established guidelines, a comprehensive understanding of the disease and treatment decisions is challenging. The main objective of this review is to derive insights from testicular GCTs (seminoma and non‐seminoma) by reviewing etiological, tumor biological, and clinical knowledge, and to thereafter suggest actions for ovarian GCTs based on this. We hypothesize that by adopting specific treatment strategies from testicular GCTs—including de‐escalating adjuvant chemotherapy for low‐risk patients and implementing more standardized and intensive treatment protocols in cases of relapse—we can improve the prognosis and minimize long‐term side effects in ovarian GCT patients.

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“…Many case series of secondary malignant transformation in GCT have been reported. The first of eleven cases was described by Ulbright in 1984, when, for the first time, the idea was theorized that the malignant elements could derive from teratomatous foci, since eight of nine cases available for review had teratoma in the primary tumor and teratoma was found in all subsequently recurring lesions (5)(6)(7)(8)(9)(10). The etiological hypothesis of this malignancy is different: given the remarkable chemo-sensitivity of GCTs, chemotherapy could eliminate the bulk of GCTs, thus exposing the non-GCT, chemo-resistant malignant components (5), or TMT could derive from histological transformation due to pluripotency of GCT components.…”

Section: Introductionmentioning

confidence: 99%

Case Report: The Complete Remission of a Mixed Germ Cell Tumor With Somatic Type Malignancy of Sarcoma Type With a GCT-Oriented Therapy: Clinical Findings and Genomic Profiling

et al. 2021

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Somatic malignant transformation in a germ cell tumor (GCT) is the development of non-germ malignancies; much of available literature refers to teratoma with malignant transformation (TMT). There are various transformation histologies such as sarcoma, adenocarcinoma, primitive neuroectodermal tumors, and more rarely carcinoid tumors, hemangioendothelioma, lymphoma, or nephroblastoma. The treatments of these entities include surgery and/or chemotherapy. A standard approach in choosing chemotherapy in TMT cases has not yet been established. Many authors suggest using chemotherapeutic agents based on the transformed histology, while others recommend GCT-oriented therapy combined with surgery as the primary treatment, reserving histology-driven chemotherapies for metastatic relapse. We report the clinical findings and the genomic profile of a mixed GCT case with somatic-type malignancy of sarcoma type. We achieved a complete radiological response with GCT-oriented chemotherapy performed as salvage therapy after sarcoma-histology therapy. In addition, molecular profiles with RNA-sequencing and exome sequencing analyses of the primary tumor and the tumor with somatic-type malignancy of sarcoma type were explored.

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Secondary malignant transformation of testicular teratomas: Case series and literature review

Cited by 5 publications

References 40 publications

Pitfalls in the diagnosis of yolk sac tumor: Lessons from a clinical trial

Pitfalls in the diagnosis of yolk sac tumor: Lessons from a clinical trial

Malignant ovarian and testicular germ cell tumors: Common characteristics but different prognoses

Case Report: The Complete Remission of a Mixed Germ Cell Tumor With Somatic Type Malignancy of Sarcoma Type With a GCT-Oriented Therapy: Clinical Findings and Genomic Profiling

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