Germ Cell Tumors of the Mediastinum

Kenneth A. Kessler, MD, Panos N. Vardas, MD, Lawrence H. Einhorn, MD

Key Points

Mature teratomas are the most common mediastinal germ cell tumor. Mature teratomas are benign with surgery representing curative therapy. Seminomatous germ cell tumors arising in the mediastinum are malignant however have high cure rates with cisplatin-based chemotherapy alone and surgery rarely indicated. Nonseminomatous germ cell tumors of mediastinal origin are malignant. Although histologically similar to their more commonly occurring testicular counterparts, primary mediastinal nonseminomatous germ cell tumors have a distinctly worse prognosis and therefore have been categorized as “poor risk” along with other subsets of testicular nonseminomatous germ cell tumors. Cisplatin-based chemotherapy followed by surgical extirpation of residual disease when feasible results in 40% to 50% overall long-term survival.

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