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Case Reports: Management Challenges in Pediatric Germ Cell Tumors
Sophie Carr1,2, Arash Safavi3, Erik D Skarsgard1
1Department of Surgery, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
Frontiers in Pediatrics
|May 3, 2021
Summary
Infant germ cell tumors are often benign and extragonadal, but can recur. Postoperative surveillance is challenging due to elevated alpha fetoprotein levels in infants.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Developmental Biology
Background:
- Germ cell tumors (GCTs) in infants are typically extragonadal and benign.
- These tumors can present with both malignant and benign components, complicating treatment.
- Retroperitoneal GCTs, though rare, can be large and locally invasive.
Observation:
- Infantile GCTs frequently occur outside the gonads and are usually benign.
- Malignant and benign GCTs can coexist, leading to recurrence risk even after incomplete resection.
- Serum alpha fetoprotein (AFP) is a malignancy marker, but its physiological elevation in infants complicates monitoring.
Findings:
- Extragonadal GCTs in infants are predominantly benign and surgically manageable.
- The presence of mixed histology (benign and malignant) poses a risk for recurrence.
- Interpreting elevated serum AFP in infants requires careful consideration of normal physiological levels.
Implications:
- Awareness of unusual GCT features in infancy is crucial for accurate diagnosis and management.
- Careful surgical planning and follow-up are necessary for infants with GCTs, especially those with mixed histology.
- Development of refined surveillance strategies is needed to overcome AFP interpretation challenges in neonates.
