Mediastinal Germ Cell Tumors: A Review and Update on Pathologic, Clinical, and Molecular Features

Research output: Contribution to journalReview articlepeer-review

Abstract

Mediastinal germ cell tumors (MGCTs) are the most common extragonadal germ cell tumors (GCTs) and most often arise in the anterior mediastinum with a male predilection. MGCTs also have a predilection for patients with Klinefelter syndrome and possibly other genetic conditions. MGCTs, as GCTs at other extragonadal sites, are thought to arise from germ cells improperly retained during migration along the midline during embryogenesis. Similar to their counterparts in the testes, MGCTs are classified into seminomatous and nonseminomatous GCTs. Seminomatous MGCT represents pure seminoma, whereas nonseminomatous MGCTs encompass pure yolk sac tumors, embryonal carcinoma, choriocarcinoma, mature or immature teratoma, and mixed GCTs with any combination of GCT types, including seminoma. Somatic-type or hematologic malignancies can also occur in association with a primary MGCT. MGCTs share molecular findings with GCTs at other sites, most commonly the presence of chromosome 12p gains and isochromosome i(12p). Treatment includes neoadjuvant chemotherapy followed by surgical resection of residual tumor, with the exception of benign teratomas, which require only surgical resection without chemotherapy. In this review, we highlight and provide an update on pathologic, clinical, and molecular features of MGCTs. Immunohistochemical profiles of each tumor type, as well as differential diagnostic considerations, are discussed.

Original languageEnglish (US)
Pages (from-to)335-350
Number of pages16
JournalAdvances in Anatomic Pathology
Volume28
Issue number5
DOIs
StatePublished - Sep 2021

Keywords

  • extragonadal germ cell tumor
  • immunohistochemistry
  • isochromosome 12p
  • mediastinum
  • molecular

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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