Primary germ cell tumors of the mediastinum are rare, accounting 1-5% among all germ cell tumors and 10% of all neoplasms in this area. Approximately 85% of these tumors occur in men with a mean age 29 years. These tumors are mainly found in the anterior mediastinum and appear grossly as large lobulated masses. They are frequently invasive at the time of diagnosis and almost 90% of patients are symptomatic. Primary nonseminomatous germ cell tumor arising in the posterior mediastinum is very rare. We report a case of 37- year old male arising from the posterior mediastinum. Serum tumors markers including alpha-fetoprotein and beta-hCG which are usually elevated in germ cell tumor were not elevated. He was found to have a primary mediastinal embryonal carcinoma with pulmonary metastasis at open exploration. He was treated with debulking surgery and cisplatin-based chemotherapy, died of sepsis after 15 months postoperatively.
alpha-Fetoproteins ; Carcinoma, Embryonal* ; Diagnosis ; Drug Therapy ; Humans ; Male ; Mediastinum* ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Sepsis

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor

OBJECTIVE: to evaluate the clinicopathologic characteristics of patients with ovarian malignant germ cell tumor. METHODS: We reviewed records of women who had malignant germ cell tumors of the ovary from 1991-2000. RESULTS: Thirty-seven women had surgical resections of malignant ovarian germ cell tumors and most received adjuvant therapy. Twenty-five women (68%) presented with stage I disease, and 12 (32%) had more advanced disease. Histology subtypes were: immature teratoma (n=16), dysgerminoma (n=9), yolk sac tumor (n=8), choriocarcinoma (n=2), embryonal carcinoma (n=1), and mixed germ cell tumor (n=1). The frequency of positive tumor markers were aFP, CA-125, beta-hCG, CA 19-9 and LDH in decreasing order. The mean age of the patients at presentation was 23.9 years (4-58). Surgical management of the 32 patients consisted of unilateral oophorectomy, or salpingo-oophorectomy, 1 woman with stage III disease underwent bilateral salpingo-oophorectomy and 4 women underwent total abdominal hysterctomy, bilateral or unilateral adnexectomy. Thirty-two women were treated with adjuvant combination chemotherapy (BEP, VAC, VBP) according to indications. The 5-year survival rate was 100%, and 5-year disease-free rate was 91.8%. Among twelve patients who attempted pregnancy, 8 succeeded in it and delivered normal full term babies. CONCLUSION: Current therapeutic strategies can allow most women with ovarian malignant germ cell tumors to have conservative surgery without compromising survival and to preserve their reproductive potential.
Carcinoma, Embryonal ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovariectomy ; Ovary* ; Pregnancy ; Survival Rate ; Teratoma ; Biomarkers, Tumor

A clinicopathologic study was per formed on 14 cases of malignant nondysgerminomatous ovari an germ cell tumors(NDOGCT) treated at the department of obstetrics and gynecology in Korea Cancer Center Hospital between Jan. l987 and,Jun. 1992. The results obtained were as follows ; 1. Median age of the patients was 27.5 years (range, 5 to 54) 2.Clinical symptoms presented were abdminal pain(64.3%), abdominal palpable mass(42.9%), abdominal distension(28.5%) in order of frequency. 3. Histopathologically, 7 cases(50%) were irnmature teratoma, 4 cases(28.6%) were endoder mal sinus tumor, 1 case(7.1%) was embryonal cell carcinoma, 2 cases(14.3%) were mixed germ cell tumor. 4. Bystage, 6 casse(42.9%) were in stage I, 1 case(7.1%) in stage Il, 2 cases(14.3%) in stage III, 3 cases(21.4%) in stage IV, and 2 cases(14.3%) in recurrence. 5, Serum alphafetoprotein was elevated in all patients withendodermal sinus tumor or embryonal carcinoma, and serum CA125 was elevated in about one half of the patients with nondysgerminomatous gerrn cell tumr. 6. l0 cases were managed by salpingo-oophorectomy with poatoperative chemotherapy, 3 cases by hysterectamy and salpingo-oophorectomy with postoperative chemotherapy. 7. Durations of follow up ranged 5 to 66 months, in that period, 5 cases were died, 4 cases were alive with disease and 4 casee wero no evidence of disease. 1 case was loat follow up after operation. All 5 patients were alive who had been treated with REP regirnen. In conelusion, prognosis of malignant NDOGCT is still poor in spite of adjuvant chemotherapy following surgery, and study ineluding appropriate chemotherapeutic regimen may be needed.
Carcinoma, Embryonal ; Chemotherapy, Adjuvant ; Drug Therapy ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Korea ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Phytolacca dodecandra ; Prognosis ; Recurrence ; Teratoma

A Clinical observation was made of 20 cases of testicular tumor admitted to the Department of Urology, Kei-myung University Medical College and Hospital during the period from May 1971 through July 1982. Among the 20 cases, 4 cases were transferred to this department for further treatment and tumor recurrence following orchiectomy. The results of clinical observation are summarized as below: 1. Age distribution was between 9 months and 57 years old, showing the highest incidence below 10 years old (65%). 2. There were 7 cases of teratoma, 5 cases of seminoma, 5 cases of embryonal carcinoma, 1 case of teratocarcinoma and 2 cases of metastatic neoplasm. 3. Stages of primary germ cell tumors; stage A 6 cases, stage B 2 cases and stage C 3 cases. 4. These patients were managed by surgery, radiation therapy and chemotherapy according to the histologic findings and clinical stages.
Age Distribution ; Carcinoma, Embryonal ; Child ; Drug Therapy ; Humans ; Incidence ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Orchiectomy ; Recurrence ; Seminoma ; Teratocarcinoma ; Teratoma ; Urology

No abstract available.
Antineoplastic Agents/*pharmacology ; Carcinoma, Embryonal/*drug therapy ; Cell Differentiation/*drug effects ; Cell Proliferation/*drug effects ; Flavonoids/*pharmacology ; Humans ; Phenols/*pharmacology ; Thyroid Neoplasms/*drug therapy

Among 60 children with teratoma, forty-three (71.7 percent) were girls and 17 (28.3 percent) boys. Primary sites were sacrococcygeal in 30 patients (50 percent), retroperitoneal in 12 (20 percent), ovarian in 11 (18.3 percent), testicular in 3 (5 percent), and one in each of nasopharyngeal, gastric, hepatic and pancreatic (1.6 percent, respectively). Fifty-five (91.7 percent) teratomas were benign and 5 (8.3 percent) malignant. Malignant teratomas were detected only at sacrococcygeal region (16.7 percent). Older than 2 months of age at diagnosis, presence of urinary and colonic obstructive symptoms, multiple masses and elevated serum alpha-fetoprotein were indicators of malignancy in sacrococcygeal region. Tumor size, presence of calcification, and gross appearance (cystic or solid) did not correlate with malignant nature. Thirteen (21.7 percent) cases were associated with other anomalies. For the immature teratoma, the operative resection without adjuvant chemotherapy was enough. Three malignant cases were survived, one with chemotheapy for 3 years and the others without chemotherapy for 5 and 10 years.
alpha-Fetoproteins ; Carcinoma, Embryonal ; Chemotherapy, Adjuvant ; Child* ; Colon ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Humans ; Sacrococcygeal Region ; Teratoma*

We reviewed 13 patients with testicular embryonal carcinoma from July 1982 to May 1994. Embryonal carcinoma accounted for about 25% of total testicular tumors(13/56) and about 34% of nonseminomatous germ cell tumors(13/38). Among the patients with embryonal carcinoma, about 85% were diagnosed in the 15-to-34 year age group. About seventy percent of the patients had metastatic disease at the time of diagnosis and 66.7% of these had distant metastasis including by lung, bone, retroperitoneal lymph node and cervical lymph node, attesting to the aggressiveness of embryonal carcinoma and its tendency to early hematogenous spread. Serum AFP was elevated in 10 patients(76.9%) and hCG in 6 patients(46.2%). All patients with stage I (4/13) were treated with radical orchiectomy only, and all patients with stage II(3/13) were treated with radical orchiectomy and retroperitoneal lymph node dissection(RPLND) followed by chemotherapy. Of the patients with stage III(6/13), 4 patients were treated with radical orchiectomy and chemotherapy, and 2 patients with radical orchiectomy and early chemotherapy, followed by RPLND. The pathologic findings of lymph node at the time of RPLND in stage III were 1 residual embryonal carcinoma and 1 fibrosis. In stage I and II, all patients were still alive. In stage III, 2 patients were still alive for 22 and 48 months. Among the 4 expired patients, 2 were from lung metastasis and the others from sepsis might caused by chemotherapy. These results suggest that the radical orchiectomy only with close clinical observation for stage l had a good survival, and long term survival in stage II patients treated with radical orchiectomy and RPLND followed by chemotherapy will be expected. And in stage III, if the side effects of the chemotherapy is reduced, the better survival may be obtained.
Carcinoma, Embryonal* ; Diagnosis ; Drug Therapy ; Fibrosis ; Germ Cells ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Orchiectomy ; Sepsis ; Testis

Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recurrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.
Biopsy ; Carcinoma, Embryonal ; Choriocarcinoma ; Diagnosis ; Drug Therapy, Combination ; Endoderm ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Incidence ; Male ; Mediastinum ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal* ; Pregnancy ; Prognosis ; Recurrence ; Strikes, Employee ; Testicular Neoplasms

A clinical observation was made on I6 patients with testicular tumors who were admitted to the Department of Urology, Hanyang University Hospital during the period from January, l973 to December, 1984. The following results were obtained. 1. During this period, testicular tumors comprised O.42% of all inpatients and 3.47% of all male G-U tract tumors. 2. The age distribution ranged from 7 months to 56 years old and showed the highest incidence in 1 year to 9 years old. 3. Among the l6 cases with testicular tumors, there were 14 cases of germ cell tumor (2 cases of seminoma with embryonal carcinoma, 8 cases of teratoma, 3 cases of embryonal carcinoma, 1 case of yolk sac tumor) and 2 cases of non-germ cell tumor (all of Leydig cell tumor). 4. The presenting symptoms were painless scrotal mass in l3 cases, painful scrotal mass in 1 case, sexual precocity in 1 case, abdominal mass in 1 case. 5. Preorchiectomy evaluation of serum AFP and HCG was made by radioimmunoassay. Four cases (2 cases of seminoma with embryonal carcinoma, 1 case of embryonal carcinoma, l case of yolk sac tumor) had elevated serum AFP. None had elevated serum HCG. 6. Radical orchiectomy was given for 15 cases. Adjuvant chemotherapy in l case of embryonal carcinoma and VAB-6 combination chemotherapy for recurred tumor in 1 case of seminoma with embryonal carcinoma were performed. 7. Follow-up study was made on 7 cases (1 case of seminoma with embryonal carcinoma, 2 cases of embryonal carcinoma, 1 case of yolk sac tumor, 3 cases of teratoma) of testicular tumors with mean duration of 49 months. Of these 7 cases, 1 case (stage C, embryonal carcinoma) died at l.5 months after orchiectomy and relapse occurred in 1 case of seminoma with embryonal carcinoma and remaining cases are alive without evidence of disease for mean follow-up 64.8 months.
Age Distribution ; Carcinoma, Embryonal ; Chemotherapy, Adjuvant ; Child ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Follow-Up Studies ; Humans ; Incidence ; Inpatients ; Male ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Orchiectomy ; Radioimmunoassay ; Recurrence ; Seminoma ; Teratoma ; Testicular Neoplasms* ; Urology ; Yolk Sac