[醫如往常] Senior Clerkship Day 107: Pathology: Mixed Germ cell tumor

SPC 梁醫師
Mixed Germ cell tumor 40M left retroperitoneal tumor with flank pain
AFP4000 ng/ml
Dopamine 550 ug/24h
Rule out
1. Castleman disease
2. Psoas fibrous tumor
3. Leiomyosarcomasarcoma
4. Liposarcoma


Calcification
Vessel invasion
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Mature teratoma GFAP
Immature
Microcystic
Schiller-Dual Body (glomerular like)
CD30 embryonal carcinoma
Yolk sac tumor cd117
Choriocarcinoma HSD3D1
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年紀越大， yolk sac tumor ratio越大
Adult may combine hematopoietic neoplasms
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Pediatric type
Age>12 is adverse
I(12p) is rare
Sacrococcygeal>>mediastinum
If it combines YST or other type, not a bad sign
Conservative approach
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Children prepubertal type
6 year survival rate >80% with platinum
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Extragonal adult type
比照non seminoma處理
常常是occult testes
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EC 是不好的
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Puberty 也可能長prepubertal type
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Germ cell neoplasm in situ 是post pubertal 特徵
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1cm3, 送cytogenetics
20000自費
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