Pediatric Malignant Sacrococcygeal Germ Cell Tumor with Intraspinal Extension

Area of Science:

• Oncology
• Neurosurgery
• Pediatric Surgery

Background:

• Sacrococcygeal malignant germ cell tumors (SC-MGCTs) are rare neoplasms.
• Intraspinal extension of SC-MGCTs presents unique management challenges.

Purpose of the Study:

• To evaluate the clinical presentation, management strategies, and outcomes of SC-MGCTs with intraspinal extension.
• To assess the efficacy of neoadjuvant chemotherapy in these rare tumors.

Main Methods:

• Retrospective review of case records for SC-MGCT patients with intraspinal extension.
• Evaluation of presentation, response to therapy, surgical resection extent, neurological recovery, and patient outcomes.
• Utilized contrast-enhanced computed tomography and magnetic resonance imaging for diagnosis.

Main Results:

• Two of three SC-MGCT cases had intraspinal extension (Altman Type 3 and 4, Stage 4).
• Both patients experienced complete tumor response to neoadjuvant chemotherapy and achieved gross complete local resection.
• Complete neurological recovery was observed in all patients, with no recurrence during follow-up.

Conclusions:

• SC-MGCTs with intraspinal extension are rare but manageable with neoadjuvant chemotherapy.
• This approach simplifies surgical excision and leads to favorable neurological and oncological prognoses.
• Early diagnosis and multimodal treatment are crucial for optimal patient outcomes.