Extragonadal germ cell tumors: Clinical presentation and management

Costantine Albany, Lawrence Einhorn

Research output: Contribution to journalArticle

45 Citations (Scopus)


PURPOSE OF REVIEW: The extragonadal germ cell tumors (EGCTs) represent a unique entity, and as such require specialized management. This review article will discuss the diagnosis, prognosis and treatment modalities for EGCTs. RECENT FINDINGS: The anterior mediastinal germ cell tumors (GCTs) are the most common EGCT. These tumors originate in the anterior mediastinum without any testis primary. Mediastinal nonseminomatous GCTs carry a poor prognosis with 40-50% overall survival and should be treated with cisplatin-based chemotherapy followed by surgical resection of the residual tumor. At Indiana University, we recommend etoposide (VP-16), ifosfamide and cisplatin (VIPx4) instead of bleomycin, etoposide and platinum (BEPx4) to prevent pulmonary complications, as these patients require extensive thoracic surgical resection. Patients who relapse have a dismal outcome with only 10% long-term survival. Our preferred treatment option is surgery for localized relapse; if surgery is not feasible, then high-dose chemotherapy with stem cell transplant in an experienced center is a reasonable approach. Retroperitoneal GCT should be treated in a similar fashion to primary testis cancer. SUMMARY: The utilization of cisplatin-based chemotherapy is associated with the best chance of cure for EGCTs. This should be followed by surgical resection of residual tumor in nonseminomatous GCT.

Original languageEnglish
Pages (from-to)261-265
Number of pages5
JournalCurrent Opinion in Oncology
Issue number3
StatePublished - May 2013


Germ Cell and Embryonal Neoplasms
Residual Neoplasm
Drug Therapy
Testicular Neoplasms
Stem Cells


  • dysgerminoma
  • extragonadal germ cell tumors
  • primary mediastinal nonseminomatous GCT
  • retroperitoneal germ cell tumors
  • teratoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Extragonadal germ cell tumors : Clinical presentation and management. / Albany, Costantine; Einhorn, Lawrence.

In: Current Opinion in Oncology, Vol. 25, No. 3, 05.2013, p. 261-265.

Research output: Contribution to journalArticle

title = "Extragonadal germ cell tumors: Clinical presentation and management",
abstract = "Lippincott Williams &Wilkins.",
keywords = "dysgerminoma, extragonadal germ cell tumors, primary mediastinal nonseminomatous GCT, retroperitoneal germ cell tumors, teratoma",
author = "Costantine Albany and Lawrence Einhorn",
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journal = "Current Opinion in Oncology",
issn = "1040-8746",
publisher = "Lippincott Williams and Wilkins",
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