title: Malignant sacrococcygeal germ cell tumour in an adult.
abstract: In adults, malignant sacrococcygeal germ cell tumour is a rare cause for a presacral tumour, with only 17 cases having been reported in the literature since 1907. We report the case of a 34 year old male who presented with a 6 month history of symptoms relating to a malignant presacral tumour which required en bloc excision including the lower sacrum and rectum. He died with lung and mediastinal metastasis 7 months following surgical excision and adjuvant chemotherapy using Cisplatin, Bleomycin and Etoposide. Prior to his death, he had a severe polyarthritis of his peripheral joints and evidence of hypertrophic osteo-arthropathy. The literature indicates that adults with these tumours have a poor prognosis, with only one reported long-term survivor. Surgical excision offers the only chance of cure, with the role of adjuvant therapy not having been defined because of the small numbers.
authors.affiliation: Department of Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: B M
authors.initials: BM
authors.lastname: Smithers
authors.forename: D E
authors.initials: DE
authors.lastname: Theile
authors.forename: I C
authors.initials: IC
authors.lastname: Dickinson
authors.forename: D B
authors.initials: DB
authors.lastname: Thomson
authors.forename: R A
authors.initials: RA
authors.lastname: Axelsen
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001168:Arthritis / Q000139:chemically induced; D001761:Bleomycin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003050:Coccyx / Q000473:pathology*; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D018237:Germinoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008479:Mediastinal Neoplasms / Q000556:secondary; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000139:chemically induced; D010386:Pelvic Neoplasms / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012447:Sacrum / Q000473:pathology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin