Extragonadal germ cell tumors: prognostic factors and long-term follow-up

[Primary choriocarcinoma of the maxillary gingival]

INTRODUCTION

Primary non-gestational extragonadal choriocarcinomas are uncommon and their head and neck localization more exceptional.

OBSERVATION

We report on a primary choriocarcinoma case of the mandibular gingivae in a 26-year-old woman who presented with pulmonary and renal metastasis. Complete response (clinical, biological and radiological) was achieved with combined chemotherapy according to APE regimen associating actinomycin, cisplatin and etoposid. The patient was free of disease 4 years after therapy completion.

DISCUSSION

Primary gingival mandibular choriocarcinoma is very rare. Clinical presentation is atypical; diagnosis is based on histopathological examination and positivity for HCG. Our case report showed high chemo-sensitivity and comparable outcome to the other localizations.

Extragonadal germ cell tumour

We report a rare case of extragonadal germ cell tumour in a 55-year-old man. He presented with a painless mass in right inguinal region, a few days after hernioplasty for right direct inguinal hernia, which caused diagnostic difficulties and treatment problems.

Primary retroperitoneal germ cell tumours: excision via a thoracoabdominal extraperitoneal approach

BACKGROUND

Primary retroperitoneal germ cell tumours usually present as a large abdominal mass in young men. The testes are normal on examination and ultrasonography but there are usually raised serum levels of human chorionic gonadotrophin and/or alpha-fetoprotein.

METHODS

Fourteen men (median age 33 years) with primary retroperitoneal germ cell tumours were treated by chemotherapy followed by surgical resection of the primary tumour and metastases via a thoracoabdominal extraperitoneal approach.

RESULTS

There was minimal morbidity. The survival rate was 13 of 14 and the disease-free survival rate was 11 of 14 after a median follow-up of 15 months.

CONCLUSION

The thoracoabdominal extraperitoneal approach for the removal of retroperitoneal germ cell tumours and their metastases after chemotherapy improves tumour clearance, morbidity and recovery time compared with the transperitoneal anterior approach.