Clinical Characteristics and Outcome of Infantile Extracranial Germ Cell
Tumors: A Multi-center 10-year Retrospective Study
Abstract
Objectives: To summarize the clinical characteristics and outcome of
infantile extracranial germ cell tumors(GCTs) from four different
centers in China since the last 10 years. Methods: Fifteen cases of
infantile extracranial GCTs diagnosed between January 1st, 2010 to
December 31st, 2019 were evaluated. Results: Nine patients were
males(60%) and six were females(40%). The median age was 5.2
months(ranges:2.4-11.8months). There were six cases(40%) in
retroperitoneum, six cases(40%) in sacrococcygeal, one case(6.6%) in
testicular, one case(6.6%) in hip and one case(6.6%) in mediastinum.
Histologically, there were 10 cases(66.6%) of immature teratoma,
3(20%) mixed GCTs and 2(13.3%) malignant GCTs. One case was
stageII(6.6%), eleven stageIII(73.3%), one stageIV(6.6%) and two
cases were unclear(13.3%). Nine cases(60%) had alpha-fetoprotein(AFP)
level of higher than 1000ng/ml. All of the cases received adjuvant
chemotherapy in which platinum-based chemotherapy regimens were mostly
used. The median follow-up time was 31 months(range: 3–81 months). At
the end of treatment, 12 patients got CR(80%), 1 PR(6.7%) and 2
NR(13.3%). During the follow-up period, 12 patients alive without
disease and 3 patient who did not got CR at the end of treatment died of
disease progression. Conclusions: Most of infantile extracranial GCTs
located outside the gonads. Sacrococcygeal and retroperitoneal regions
were common sites. Histologically, teratoma was more common in infantile
GCTs. Early diagnosis is needed and chemotherapy regimen needs to be
further standardized in China. An evaluation system is needed to figure
out treatment efficacy and prognosis in the future.