Surgery For Extragonadal Germ Cell Tumor Of Mediastinum

Germ cell tumors occur predominantly from the testicles. However, 2-5% of all germ cell tumors in adult men have extargonadal localization. Germ cell tumors (GCTs) are classified as extragonadal if there is no evidence of a primary tumor in the testes or ovaries.
Extragonadal GCTs typically arise in midline locations, and specific sites vary with age. In adults, the most common sites, in order of frequency, are the anterior mediastinum, retroperitoneum, and the pineal and suprasellar regions.
Extragonadal GCTs in mediastinum are also rare. That is a frequent cause of diagnostic errors, which are of fundamental importance in the fate of the patients. Unfortunately, many patients with chemoresistant tumors receive multiple courses of chemotherapy for other, more frequent mediastinal malignant pathologies, such as lymphoma, thymoma and etc.
Morphological diagnosis also can be difficult. Often there are false-negative results.
In this clinical case, primarily germ cell tumor was wrongly regarded as thymoma B3. The most effective way to diagnose GCTs - AFP, hCG and LDG in blood. Video by Dr Ilya Gotsadze