Abdominal wall mixed malignant germ cell tumor: a case report and review of literature.
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Abdominal wall mass is not uncommon in clinic, but it is very rare that germ cell tumors (GCTs) arise in the abdominal wall. The authors review the case of a 34-year-old female with abdominal wall mixed malignant GCT composed of embryonal carcinoma and teratoma and combine the relative literature to explain why GCTs originate from anterior abdominal wall.Keywords:
Abdominal mass
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Germ-cell malignant tumours occurred in a man and his son. The father, who had a teratoma of the right testicle removed 24 years ago, is presently alive and well. The son, who had a choriocarcinoma presenting as an abdominal mass, possibly originating in the testicle, died within 7 months of the diagnosis with metastases in the lungs, liver and retroperitoneum. This report documents the third such case of germ-cell neoplasms occurring in father and son.
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The pineal region is an anatomic location where various intracranial tumors, in particular germ cell tumors and pineal parenchymal tumors, occur. Interestingly, pineal germ cell tumors are detected more frequently in Asian countries, including Japan, while pineal parenchymal tumors are less frequent in Asia than in the United States and Europe.This publication takes advantage of the knowledge and experience of Japanese experts in pineal tumors, with emphasis on epidemiology and pathological diagnosis. A variety of treatment modalities including radiotherapy, radiosurgery, surgical therapy and chemotherapy are also discussed.This valuable book will enhance the knowledge on pineal tumor treatment of not only neurosurgeons and radiation oncologists but also neurologists, neuro-oncologists, pediatricians and neuropathologists interested in pineal region tumors.
Germinoma
Placental alkaline phosphatase
Human chorionic gonadotropin
Embryonal carcinoma
Immature teratoma
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Embryonal carcinoma
Neoplasm
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Germ cell tumours infrequently metastasise to body cavities, where early detection on fluid samples is possible and can spearhead early treatment and survival.A total of seven cases of metastatic germ cell tumours were retrieved out of 7500 effusion samples received for cytopathological examination from 2015 to 2021. Detailed cytological features of metastatic germ cell tumours in effusion samples were studied, along with a correlation between clinical, radiological, and histopathological features.A total of seven cases of metastatic germ cell tumours were analysed in effusion samples which included dysgerminoma (2), immature teratoma (2), yolk sac tumour (1), embryonal carcinoma (1), and mixed germ cell tumour (1). The smears showed predominantly discrete or loose clusters of cells. The cells with round nuclei and prominent nucleoli were helpful in detecting dysgerminoma and yolk sac tumours. Immature teratoma showed tiny groups of small cells and mature squamous cells. Serum tumour markers were raised in the majority of cases.Metastatic germ cell tumours in effusion are uncommon, but detailed clinical history, including serum markers and characteristic cytological features, are helpful in their diagnosis.
Dysgerminoma
Immature teratoma
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Mixed germ cell tumors of ovary are malignant neoplasms of the ovary comprising of two or more types of germ cell components. The combination of various elements occurs in approximately 8 percentage of cases. The most common combination is that of dysgerminoma with yolk sac tumor, but other combinations including teratoma, choriocarcinoma, embryonal carcinoma etc may also occur. These tumors mainly affect young girls and women of reproductive age group. Hence its identification and diagnosis assumes importance for the treatment. Here a case of mixed germ cell tumor of ovary is presented. A 15 year old girl presented with abdominal pain, abdominal mass and irregular bleeding. MRI showed huge pelvic mass. Tumor markers AFP, Beta HCG, LDH were elevated. Tumor was excised. Histopathological examination showed mixed germ cell tumor with components of yolk sac tumor with dysgerminoma, embryonal carcinoma, teratoma and choriocarcinoma
Dysgerminoma
Immature teratoma
Embryonal carcinoma
Abdominal mass
Struma ovarii
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Abdominal wall mass is not uncommon in clinic, but it is very rare that germ cell tumors (GCTs) arise in the abdominal wall. The authors review the case of a 34-year-old female with abdominal wall mixed malignant GCT composed of embryonal carcinoma and teratoma and combine the relative literature to explain why GCTs originate from anterior abdominal wall.
Abdominal mass
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We present the interesting case of a 38‐year‐old man with a primary malignant tumor of the right testis that metachronously metastasized to the urinary bladder and the stomach. Histologically, the testicular tumor was a mixed germ cell tumor composed of teratoma and embryonal carcinoma, but it also contained a sarcoma component of somatic type malignancy. Metastases showed rhabdomyoblastic differentiation histologically identical to the sarcoma component of the testicular tumor that was diagnosed as rhabdomyosarcoma. By applying fluorescence in situ hybridization (FISH) to the cytogenetic examination of cells taken from the periventricular lymph node metastases, we demonstrated a structural chromosomal aberration characteristic of testicular neoplasms, i.e. the presence of isochromosome 12p (i(12p)). Additionally, the diagnosis was supported by immunohistochemistry.
Embryonal rhabdomyosarcoma
Embryonal carcinoma
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An unusual case of encephalomyeloneuritis associated with germ cell tumor with mature and immature teratoma arising int he mediastinum is presented. There was an unusually long interval from the onset of neurologic symptoms to the development of malignancy. The histopathology, characterized by limbic encephalitis, brain stem encephalitis, cortical cerebellar degeneration and myeloneuritis, was similar to that of paraneoplastic encephalomyeloneuritis previously described in the literature. Virological and immunological studies failed to demonstrate any causative agents or autoantibodies reacting with brain tissue. The causal relationship between the malignant neoplasm and encephalomyeloneuritis thus seems to be very complex.
Paraneoplastic cerebellar degeneration
Histopathology
Mature teratoma
Neoplasm
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The clinicopathological features of atypical teratoid/rhabdoid tumor, a new entity among malignant pediatric brain tumors, and the differential diagnosis from primitive neuroectodermal tumor (PNET)/ medulloblastoma, and germ cell tumor are described. Histologically, atypical teratoid/rhabdoid tumor is defined as a polymorphous neoplasm often featuring rhabdoid, PNET, epithelial, and mesenchymal components. Atypical teratoid/rhabdoid tumors usually include PNET components and occur mainly in the posterior fossa, so mimic medulloblastoma. Atypical teratoid/rhabdoid tumor is characterized by the cytogenetic finding of monosomy 22 rather than i(17q). The tumor is similarly mistaken for PNET at supratentorial sites. Germ cell tumors also enter into the differential diagnosis due to their histological immunophenotypic diversity, particularly features indicative of epithelial and mesenchymal differentiation. Nonetheless, the remarkable spectrum of tissues that typify teratoma is absent in atypical teratoid/rhabdoid tumor. The same is true of germ cell marker in tumor tissues and serum. The prognosis of atypical teratoid/rhabdoid tumor is far less favorable than that of PNET/medulloblastoma of malignant or germ cell tumor. Meta-analysis of 133 cases, including 15 new and 118 reported cases, confirm that atypical teratoid/rhabdoid tumor is as a clinicopathological entity and emphasizes the necessity for distinguishing this unique tumor from other pediatric central nervous system neoplasms.
Primitive neuroectodermal tumor
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Retroperitoneal lymph node metastases from testicular germ cell tumor are common, but fungation of such mass through the anterior abdominal wall is extremely rare. We report such a case which had a favorable response to chemotherapy.
Anterior wall
Abdominal mass
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