2020 Volume 57 Issue 1 Pages 1-6
Background: Germ cell tumors (GCTs) constitute a highly heterogeneous group of neoplasms that develop across a wide age range and vary in site and histological and clinical behaviors. We examined the outcomes at our institution to determine the clinical features of pediatric GCTs.
Patients and Methods: We retrospectively reviewed the medical records of 63 patients with extracranial GCTs from 2003 to 2017.
Results: The median age at diagnosis was 6.6 years (range, 10 days–14 years). The primary tumor sites were the ovary (40), testis (9), sacrococcygeal region (7), and mediastinum (7). As for histopathological findings, mature teratoma was identified in 41 patients, immature teratoma in 6 patients, yolk sac tumor in 11 patients, mixed GCT with yolk sac tumor components in 3 patients, and choriocarcinoma in 1 patient. One patient did not undergo any surgical tissue sampling because of cerebral hemorrhage from brain metastasis. Thirteen patients, including those with recurrence, were treated with platinum-based chemotherapy, and remission was achieved in 11 patients (85%).
Conclusions: Malignant germ cell tumors are sensitive to platinum-based chemotherapy, and thus, it is possible to manage patients with relapse with salvage chemotherapy and to reduce the tumor volume with neoadjuvant chemotherapy. In our patient, neoadjuvant chemotherapy can help achieve complete surgical resection. Therefore, neoadjuvant chemotherapy and delayed tumor resection should be considered in patients in whom complete resection would be difficult at initial surgery because of large tumor size or peritoneal dissemination.
