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Concurrent Primary Mediastinal Germ Cell Tumor and Acute Myeloid Leukemia: Case Report of Sustained Remission and Review of the Literature
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  • Kristina Zalewski,
  • Evan Cantor,
  • Roland Chu,
  • Rajen Mody,
  • Greg Yanik,
  • Laura Sedig
Kristina Zalewski
University of Michigan Department of Pediatrics

Corresponding Author:[email protected]

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Evan Cantor
Connecticut Children's Medical Center
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Roland Chu
Central Michigan University College of Medicine
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Rajen Mody
University of Michigan Department of Pediatrics
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Greg Yanik
University of Michigan Department of Pediatrics
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Laura Sedig
University of Michigan Department of Pediatrics
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Abstract

Abstract: Introduction: Germ cell tumors (GCT) encompass a wide variety of neoplasms with varying clinical behavior dependent on histology, staging, and site. GCT remain relatively uncommon in the pediatric population and most patients have a favorable prognosis. However, the well-established co-occurrence of primary mediastinal GCT (PMGCT) and acute myeloid leukemia (AML) has a dismal prognosis with few reported patients achieving sustained remission. Case presentation: An 18 y.o. male was concurrently diagnosed with PMGCT and AML, type M7. Cytogenetic analysis revealed a complex set of chromosomal alterations along with homozygous deletion of TP53. His concurrent oncologic processes were managed with a variety of chemotherapy regimens, complete surgical resection of the mediastinal mass, and hematopoietic stem cell transplant (HSCT). He is one of few patients with concurrent PMGCT and AML able to achieve remission with no evidence of disease nearly 5 years after completion of treatment. Conclusion: The rare, but well-identified, association between PMGCT and concurrent or subsequent AML has a dismal prognosis. Modern genetics sequencing has identified common aberrations, including i(12p), trisomy/tetrasomy 8, TP53, and PTEN mutations. With this knowledge, it may allow for future tailoring of therapy to improve the predicted outcome of patients with PMGCT and AML.
08 Mar 2024Submitted to Pediatric Blood & Cancer
08 Mar 2024Submission Checks Completed
08 Mar 2024Assigned to Editor
08 Mar 2024Review(s) Completed, Editorial Evaluation Pending
08 Mar 2024Editorial Decision: Revise Minor
23 Mar 20241st Revision Received
23 Mar 2024Submission Checks Completed
23 Mar 2024Assigned to Editor
23 Mar 2024Review(s) Completed, Editorial Evaluation Pending
27 Mar 2024Editorial Decision: Accept