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Diagnosis
Mediastinal Abnormalities
Primary Neoplasms
Nonseminomatous Malignant Germ Cell Neoplasm
Nonseminomatous Malignant Germ Cell Neoplasm
Aletta Ann Frazier, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Malignant germ cell neoplasm (MGCN)
                • Nonseminomatous germ cell tumor (NSGCT)

              • Definitions

                • Primary malignant mediastinal MGCN
                  • Yolk sac (endodermal sinus) tumor
                  • Choriocarcinoma
                  • Embryonal carcinoma
                  • Mixed-type germ cell neoplasm (GCN)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • PET/CT

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Bonouvrie K et al: Klinefelter syndrome and germ cell tumors: review of the literature. Int J Pediatr Endocrinol. 2020:18, 2020
                                              2. Kesler KA et al: Outcomes following surgery for primary mediastinal nonseminomatous germ cell tumors in the cisplatin era. J Thorac Cardiovasc Surg. 161(6):1947-59.e1, 2020
                                              3. Oosterhuis JW et al: Mediastinal germ cell tumors: many questions and perhaps an answer. J Clin Invest. 130(12):6238-41, 2020
                                              4. Stram AR et al: Mediastinal germ cell tumors: updates in diagnosis and management. Surg Oncol Clin N Am. 29(4):571-9, 2020
                                              5. Taylor J et al: Germ cell tumors and associated hematologic malignancies evolve from a common shared precursor. J Clin Invest. 130(12):6668-76, 2020
                                              6. Gu L et al: Clinical and radiographic characterization of primary seminomas and nonseminomatous germ cell tumors. Niger J Clin Pract. 22(3):342-9, 2019
                                              7. Magudia K et al: Unusual imaging findings associated with germ cell tumors. Radiographics. 39(4):1019-35, 2019
                                              8. Chahoud J et al: Managing seminomatous and nonseminomatous germ cell tumors. Curr Opin Oncol. 30(3):181-8, 2018
                                              9. Burke A et al: Choriocarcinoma. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 532-3, 2017
                                              10. Burke A et al: Embryonal carcinoma. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 530-2, 2017
                                              11. Burke A et al: Mediastinal germ cell tumor with somatic-type and hematologic malignancy. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 535-8, 2017
                                              12. Burke A et al: Mediastinal germ cell tumors: classification and overview. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 519-21, 2017
                                              13. Burke A et al: Mixed Germ Cell Tumors. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 533-5, 2017
                                              14. Burke A et al: Yolk sac tumor. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 527-30, 2017
                                              15. Carter BW et al: Approaching the patient with an anterior mediastinal mass: a guide for radiologists. J Thorac Oncol. 9(9 Suppl 2):S110-8, 2014
                                              16. Liu Y et al: Management of the primary malignant mediastinal germ cell tumors: experience with 54 patients. Diagn Pathol. 9:33, 2014
                                              17. Miettinen M et al: SALL4 expression in germ cell and non-germ cell tumors: a systematic immunohistochemical study of 3215 cases. Am J Surg Pathol. 38(3):410-20, 2014
                                              18. Albany C et al: Extragonadal germ cell tumors: clinical presentation and management. Curr Opin Oncol. 25(3):261-5, 2013
                                              19. Ueno T et al: Spectrum of germ cell tumors: from head to toe. Radiographics. 24(2):387-404, 2004
                                              20. Rosado-de-Christenson ML et al: From the archives of the AFIP. Mediastinal germ cell tumors: radiologic and pathologic correlation. Radiographics. 12(5):1013-30, 1992
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Malignant germ cell neoplasm (MGCN)
                                                            • Nonseminomatous germ cell tumor (NSGCT)

                                                          • Definitions

                                                            • Primary malignant mediastinal MGCN
                                                              • Yolk sac (endodermal sinus) tumor
                                                              • Choriocarcinoma
                                                              • Embryonal carcinoma
                                                              • Mixed-type germ cell neoplasm (GCN)

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • PET/CT

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Bonouvrie K et al: Klinefelter syndrome and germ cell tumors: review of the literature. Int J Pediatr Endocrinol. 2020:18, 2020
                                                                                          2. Kesler KA et al: Outcomes following surgery for primary mediastinal nonseminomatous germ cell tumors in the cisplatin era. J Thorac Cardiovasc Surg. 161(6):1947-59.e1, 2020
                                                                                          3. Oosterhuis JW et al: Mediastinal germ cell tumors: many questions and perhaps an answer. J Clin Invest. 130(12):6238-41, 2020
                                                                                          4. Stram AR et al: Mediastinal germ cell tumors: updates in diagnosis and management. Surg Oncol Clin N Am. 29(4):571-9, 2020
                                                                                          5. Taylor J et al: Germ cell tumors and associated hematologic malignancies evolve from a common shared precursor. J Clin Invest. 130(12):6668-76, 2020
                                                                                          6. Gu L et al: Clinical and radiographic characterization of primary seminomas and nonseminomatous germ cell tumors. Niger J Clin Pract. 22(3):342-9, 2019
                                                                                          7. Magudia K et al: Unusual imaging findings associated with germ cell tumors. Radiographics. 39(4):1019-35, 2019
                                                                                          8. Chahoud J et al: Managing seminomatous and nonseminomatous germ cell tumors. Curr Opin Oncol. 30(3):181-8, 2018
                                                                                          9. Burke A et al: Choriocarcinoma. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 532-3, 2017
                                                                                          10. Burke A et al: Embryonal carcinoma. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 530-2, 2017
                                                                                          11. Burke A et al: Mediastinal germ cell tumor with somatic-type and hematologic malignancy. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 535-8, 2017
                                                                                          12. Burke A et al: Mediastinal germ cell tumors: classification and overview. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 519-21, 2017
                                                                                          13. Burke A et al: Mixed Germ Cell Tumors. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 533-5, 2017
                                                                                          14. Burke A et al: Yolk sac tumor. In Practical Thoracic Pathology: Diseases of the Lung, Heart and Thymus. 1st ed. Wolters Kluwer. 527-30, 2017
                                                                                          15. Carter BW et al: Approaching the patient with an anterior mediastinal mass: a guide for radiologists. J Thorac Oncol. 9(9 Suppl 2):S110-8, 2014
                                                                                          16. Liu Y et al: Management of the primary malignant mediastinal germ cell tumors: experience with 54 patients. Diagn Pathol. 9:33, 2014
                                                                                          17. Miettinen M et al: SALL4 expression in germ cell and non-germ cell tumors: a systematic immunohistochemical study of 3215 cases. Am J Surg Pathol. 38(3):410-20, 2014
                                                                                          18. Albany C et al: Extragonadal germ cell tumors: clinical presentation and management. Curr Opin Oncol. 25(3):261-5, 2013
                                                                                          19. Ueno T et al: Spectrum of germ cell tumors: from head to toe. Radiographics. 24(2):387-404, 2004
                                                                                          20. Rosado-de-Christenson ML et al: From the archives of the AFIP. Mediastinal germ cell tumors: radiologic and pathologic correlation. Radiographics. 12(5):1013-30, 1992