title: Mediastinal germ cell tumors in childhood.
abstract: BACKGROUND
  Mediastinal germ cell tumors (GCTs) are rare and usually located in anterior mediastinum. We aimed to review clinical and pathological characteristics of these tumors.
  
  
  METHODS
  Between 1973 and 2011, 24 children with mediastinal GCTs were diagnosed. Hospital files were reviewed for presenting complaints, clinical, radiological and other laboratory data, surgical practices, treatments, and outcomes.
  
  
  RESULTS
  Median age was 4.5 years (0.2-16) (male/female: 10/14). Most common initial complaints were dyspnea, cough, anorexia/fatigue, fever, and chest pain. Primary tumors were located in anterior mediastinum (n = 22), posterior mediastinum (n = 1), and sternum (n = 1). Thirteen of 24 cases had mature teratomas (54.2%); four (16.7%) endodermal sinus tumor (EST); four (16.7%) immature teratomas; and one (4.2%) each of embryonal carcinoma, teratocarcinoma, and malignant teratoma. Mature teratomas underwent only surgical resection and were under follow-up without disease. Four cases with ESTs received chemotherapy and radiotherapy (n = 3), three underwent surgical resections: three died, one was followed for 284 months in remission. All but one immature teratomas were treated with surgery and all were under follow-up without disease. Two patients with embryonal carcinoma and malignant teratoma didn't undergo surgery; both received chemotherapy and radiotherapy but died with disease. The patient with teratocarcinoma was treated with surgery and chemotherapy but died with disease.
  
  
  CONCLUSIONS
  No adjuvant therapy is needed for mature teratomas. Immature teratomas must be under close follow-up for recurrences. Prognosis for mediastinal malignant GCTs was poor. These cases need intensive chemotherapies and effective local control measures as surgery -/+ radiotherapy to ensure long-term survival.
authors.affiliation: Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Yalçın
authors.forename: Hacı Ahmet
authors.initials: HA
authors.lastname: Demir
authors.forename: Feridun Cahit
authors.initials: FC
authors.lastname: Tanyel
authors.forename: Zühal
authors.initials: Z
authors.lastname: Akçören
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.forename: Canan
authors.initials: C
authors.lastname: Akyüz
authors.forename: Tezer
authors.initials: T
authors.lastname: Kutluk
authors.forename: Münevver
authors.initials: M
authors.lastname: Büyükpamukçu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000628:therapy; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome