Three cases of mediastinal germ cell tumors and concurrent hematologic malignancy and literature review
10.3760/cma.j.cn101070-20201012-01606
- VernacularTitle:纵隔生殖细胞肿瘤并发恶性血液病3例并文献复习
- Author:
Yan SU
1
;
Huimin HONG
;
Qian ZHAO
;
Libing FU
;
Mei JIN
;
Huyong ZHENG
;
Qi ZENG
;
Xiaoli MA
Author Information
1. 国家儿童医学中心，首都医科大学附属北京儿童医院儿童肿瘤中心肿瘤内科；北京市儿童血液肿瘤重点实验室；儿科重大疾病研究教育部重点实验室，北京 100045
- Keywords:
Mediastinum;
Germ cell tumors;
Hematologic malignancy;
Leukemia
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(5):377-381
- CountryChina
- Language:Chinese
-
Abstract:
To analyze the clinical characteristics, treatment and prognosis of mediastinal germ cell tumors (GCTs) with concurrent hematologic malignancy (HM). The clinical features, treatment and prognosis of 3 cases of HM associated with mediastinal GCTs treated in the Department of Medical Oncology, Beijing Children′s Hospital from November 2014 to September 2018 were retrospectively analyzed.Meanwhile, relevant cases were searched in the PubMed and Wanfang database from their establishment to December 2019.Three male cases of HM associated with mediastinal GCTs aged from 12 to 16 years.The pathogenesis of mediastinal masses suggested teratoma or yolk sac tumor.All of them were treated with surgery and chemotherapy.Acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) was diagnosed respectively at 5 months, 9 months and 31 months after initial GCTs in the 3 cases.Two patients died and 1 child survived at the last follow-up.A total of 135 cases of concurrent GCTs and HM (or leukemia) were reviewed in online databases, involving 127 cases (94.1%) with the mediastinal GCTs associated with HM and 8 cases(5.9%) with GCTs related HM from another original sites.One hundred and twenty-six cases (99.2%) were male and the median age of GCTs diagnosis was 22 (10-48) years.Fifty-three cases (41.7%) were teratoma and 94 cases (74.0%) were GCTs containing teratoma with or without yolk sac tumor.Among the types of HM, 72 cases (56.7%) were AML and 31 cases (24.4%) were AML-M7.The median interval between GCTs and HM was 3 (0-122) months.Forty-six cases (36.2%) presented 2 malignancies simultaneously.HM were diagnosed within 12 months of GCTs in 85 cases (66.9%). The survival data were known in 107 cases, involving 94 (87.9%) deaths and 13 (12.1%) survivors.The median survival time after diagnosis of HM was 2 (0-48) months.The tendency of HM must be highly concerned in adolescent male patients with primary mediastinal GCTs, especially those with yolk sac tumor or teratoma.Their prognoses are very poor.Allogeneic hematopoietic stem cell transplantation is an alternative treatment.
