Germ cell tumours of the mediastinum: an analysis and comprehensive update research on their pathological, clinical, and molecular characteristics

Abstract

Author(s): Ramesh Manmal Oswal, Kavina Ganapathy, Prabhat Sharma, Vikram Shete, Heena Baria, Sudhanshu Dev

The most frequent Extragonadal Germ Cell Tumours (EGCTs) are Mediastinal Germ Cell Tumours (MGCTs), which tend to develop in men and most frequently appear in the anterior mediastinum. Those with Klinefelter syndrome and probably other genetic diseases are also more likely to receive MGCTs. It is believed that MGCTs, like GCTs at other extragonadal locations, develop from germ cells that migrate incorrectly along the midline during development. The seminomatous and non-seminomatous GCT subtypes of MGCTs are categorized similarly to those seen in the testes. Non-seminomatous MGCTs include embryonal carcinoma, mature or immature teratoma, pure Yolk Sac Tumours (YSTs), mixed GCTs, and choriocarcinoma with any combination of GCT types, including semi-noma. Seminomatous MGCTs are pure semi-noma. Hematologic or somatic cancers may potentially develop concurrently with a primary MGCT. Except for benign teratomas, which simply require surgical removal without chemotherapy, treatment involves neoadjuvant chemotherapy followed by surgical resection of the remaining tumour. It highlights and update the molecular, clinical, and pathologic aspects of MGCTs in this review. There includes a discussion of the Immuno Histochemical (IHC) characteristics of each tumour type and other diagnostic methods.

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