Sacrococcygeal Germ Cell Tumors Research Articles

Sacrococcygeal Germ Cell Tumors: Differential Features between Benignancy and Malignancy on MR and CT Imaging

Sacrococcygeal Germ Cell Tumors: Differential Features between Benignancy and Malignancy on MR and CT Imaging

Imaging of sacrococcygeal germ cell tumors.

Sacrococcygeal teratoma is the most common solid tumor in neonates. Malignant sacrococcygeal germ cell tumors also occur in infants and children. Diagnostic imaging studies help confirm the diagnosis of a clinically palpable sacrococcygeal mass, determine its relationship to other structures, and detect metastases. Despite the relative frequency of sacrococcygeal germ cell tumors, characteristics of these lesions as evaluated with computed tomography (CT) and magnetic resonance (MR) imaging have received little attention in radiologic literature. We outline important clinical information, review the spectrum of manifestations of these tumors with traditional imaging studies, and illustrate the value of CT and MR imaging for diagnosis and staging of sacrococcygeal germ cell tumors.

Combination chemotherapy in malignant non-seminomatous germ-cell tumors: results of a cooperative study of the German Society of Pediatric Oncology (MAKEI 83)

In January 1983, the German Society of Pediatric Oncology started a cooperative trial (MAKEI 83) for non-testicular germ-cell tumors. The pilot phase closed in December 1985. The treatment regimen was stratified according to histology, tumor site and tumor stage. In malignant non-seminomatous germ-cell tumors (mNSGCTs), chemotherapy consisted of four courses of 3 mg/m2 vinblastine, on days 1 and 2 and 15 mg/m2 bleomycin on days 1-3, given by continuous infusion, and 20 mg/m2 cisplatin on days 4-8 with mannitol diuresis. Courses were repeated every 3 weeks. In mNSGCT patients with ovarian FIGO stages III-IV or extragonadal primaries, second-look surgery was carried out, followed by four additional courses of chemotherapy with 100 mg/m2 VP-16 on days 1-3, 1.5 g/m2 ifosfamide on days 1-5 with mesna uroprotection and 20 mg/m2 cisplatin on days 1-5 with mannitol diuresis. In patients with sacrococcygeal germ-cell tumors, en bloc resection of the tumor, including the coccygeal bone, was mandatory. During the registration period, 57 patients with mNSGCTs were entered: 37 protocol patients and 20 follow-up patients. The event-free survival for protocol patients at 57 months was 78% +/- 6% and that for follow-up patients was 40% +/- 10% (Kaplan-Meier): the crude survival for both groups was 83% +/- 6% and 54% +/- 12%, respectively. After a review by a panel of pathologists, the histological diagnoses in 7% of all registered cases of germ-cell tumors were changed. The results of the present studies show that the histological subclassification of mNSGCTs, tumor site and tumor stage no longer had prognostic value.

Sacrococcygeal germ cell tumors in children: W. Desheng, et al. Chin J Pediatr Surg 4:87–88, (June), 1983

Sacrococcygeal germ cell tumors in children: W. Desheng, et al. Chin J Pediatr Surg 4:87–88, (June), 1983

Sacrococcygeal germ cell tumors in childhood: An updated experience with 118 patients

The histopathology of 118 sacrococcygeal germ cell tumors (SGCT) was correlated with clinical presentation, therapeutic management, and prognosis. There were 97 teratomas (78 mature, 19 immature), 19 embryonal, and 2 anaplastic carcinomas. Mature and immature teratomas usually presented externally (AAP type I) permitting relatively early detection and surgical removal. The immature group was significantly larger (11.6 cm vs. 7.5 cm) with a greater incidence of subsequent embryonal carcinoma (16%). The embryonal and anaplastic carcinomas were diagnosed at a later age (average 21 mo) and had a substantial presacral or endopelvic component (AAP types II-IV); this group had the worst prognosis with no survivors. Our data suggest that combined analysis of clinical findings and histopathology may help to identify some of the children at risk for early recurrence.