title: Post-chemotherapy resection of nonseminomatous germ cell testicular tumors metastatic to the mediastinum.
abstract: OBJECTIVE
  We determined if the behavior of germ cell tumors metastatic to the mediastinum is different from that of primary mediastinal germ cell tumors, a group known to have distinct clinical features.
  
  
  METHODS
  A search of the computerized data base for germ cell tumors metastatic to the mediastinum at our university revealed 80 patients, 65 of whom underwent concomitant retroperitoneal lymph node dissection at mediastinal surgery.
  
  
  RESULTS
  Of the patients 60 (75%) are free of disease, 14 (18%) died of cancer and 6 (8%) are living with disease. Mediastinal pathology included teratoma in 65% of the patients, cancer in 26% and fibrosis in 9%. Of the 65 patients who underwent retroperitoneal lymph node dissection 75% had teratoma, 15% had fibrosis and 10% had cancer. Mediastinal relapses after dissection were rare (4 of 80 patients).
  
  
  CONCLUSIONS
  Germ cell tumors metastatic to the mediastinum appear to behave similarly to those metastatic to the retroperitoneum. Primary mediastinal germ cell tumors have an entirely different clinical course. Teratoma is the predominant pathological type of post-chemotherapy germ cell cancer metastatic to the mediastinum.
authors.affiliation: Department of Urology, Indiana University Medical Center, Indianapolis, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hejase
authors.forename: J P
authors.initials: JP
authors.lastname: Donohue
authors.forename: R S
authors.initials: RS
authors.lastname: Foster
authors.forename: R
authors.initials: R
authors.lastname: Bihrle
authors.forename: C L
authors.initials: CL
authors.lastname: Coogan
authors.forename: R G
authors.initials: RG
authors.lastname: Rowland
authors.forename: G R
authors.initials: GR
authors.lastname: Wahle
mesh_terms: D000293:Adolescent; D000328:Adult; D018237:Germinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology*