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Germ Cell Tumors of the Mediastinum

Kenneth A. Kessler MD, Panos N. Vardas MD, Lawrence H. Einhorn MD
Germ Cell Tumors of the Mediastinum is a topic covered in the Pearson's General Thoracic.

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Key Points

  • Mature teratomas are the most common mediastinal germ cell tumor. Mature teratomas are benign with surgery representing curative therapy.
  • Seminomatous germ cell tumors arising in the mediastinum are malignant however have high cure rates with cisplatin-based chemotherapy alone and surgery rarely indicated.
  • Nonseminomatous germ cell tumors of mediastinal origin are malignant. Although histologically similar to their more commonly occurring testicular counterparts, primary mediastinal nonseminomatous germ cell tumors have a distinctly worse prognosis and therefore have been categorized as “poor risk” along with other subsets of testicular nonseminomatous germ cell tumors. Cisplatin-based chemotherapy followed by surgical extirpation of residual disease when feasible results in 40% to 50% overall long-term survival.

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Key Points

  • Mature teratomas are the most common mediastinal germ cell tumor. Mature teratomas are benign with surgery representing curative therapy.
  • Seminomatous germ cell tumors arising in the mediastinum are malignant however have high cure rates with cisplatin-based chemotherapy alone and surgery rarely indicated.
  • Nonseminomatous germ cell tumors of mediastinal origin are malignant. Although histologically similar to their more commonly occurring testicular counterparts, primary mediastinal nonseminomatous germ cell tumors have a distinctly worse prognosis and therefore have been categorized as “poor risk” along with other subsets of testicular nonseminomatous germ cell tumors. Cisplatin-based chemotherapy followed by surgical extirpation of residual disease when feasible results in 40% to 50% overall long-term survival.

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Last updated: January 5, 2021