Abstract
Eighty patients with germ cell tumors were diagnosed at the Children's Hospital, University of Helsinki, between 1968 and 1986. The primary tumors were malignant in 22 and benign in 58 patients. 35/58 of the benign tumors were sacrococcygeal teratomas of newborns. Four of these 35 patients subsequently developed a malignant yolk sac tumor. Serial samples from patients with a primary malignancy were assayed for AFP, placental proteins hCG and SP1, and two new tumor markers CA 12-5 and CA 19-9. AFP was elevated at diagnosis in 8/11, placental protein in 4/8, CA 12-5 and CA 19-9 in 1/8 patients. Ten patients operated for a sacrococcygeal teratoma in the newborn period were followed monthly by a panel of tumor markers. Three of these patients developed a malignant yolk sac tumor at age 8-19 months. AFP values became elevated in all 3 cases and SP1 in one. One recurrence was also associated with a slightly elevated CA 12-5. Patients with germ cell tumors should be carefully followed up by a panel of tumor markers in order to gain information how to detect the potential cases of subsequent malignancy.
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