Table 1 Clinicopathologic characteristics of patients with primary anterior mediastinal mixed germ cell tumors and IDH1/2 mutational status of cartilaginous teratoma component.
Case | Age at Diagnosis (years)/Sex | Biopsy Diagnosis | Initial AFP Tumor Marker (ng/mL) | Initial ß-HCG Serum Level (IU/L) | Treatment | Resection Diagnosis | Tumor Size (cm) | Moran and Suster Proposed Clinical Staging | Follow-Up (months post resection) | IDH1/2 Mutational Status |
|---|---|---|---|---|---|---|---|---|---|---|
1 | 33/M | N/A | >4000 | N/A | Neoadjuvant VIP chemo (4 cycles), resection | Mixed GCT composed of mature teratoma and yolk sac tumor with focus of ENT | 8.5 | Stage I | DOD, acute megakaryoblastic leukemia (39) | Wild-type |
2 | 27/M | N/A | >9000 | N/A | Neoadjuvant BEP chemo (4 cycles), HD chemo with autologous SCT, resection | Mixed GCT (90% yolk sac tumor, 10% mature teratoma) | 13.0 | Stage IIIA (pleural nodules) | DOD (2) | Wild-type |
3 | 25/M | Mixed GCT, likely yolk sac tumor | 22,510 | 99 | Neoadjuvant VIP chemo (4 cycles), resection | Mature teratoma | 19.0 | Stage II | DOD (50) | Wild-type |
4 | 24/M | Immature teratoma | 281 | 53,074 | Neoadjuvant BEP chemo (2 cycles), HD chemo with autologous SCT, whole brain radiation, resection, palliative chemo | Mature teratoma | 12.1 | Stage IIIB (brain, lung and liver mets) | DOD (12) | Wild-type |
5 | 30/M | N/A | N/A | N/A | Neoadjuvant VIP chemo (4 cycles), resection, lung metastasectomy | Mature teratoma | 20.5 | Stage IIIA (lung mets) | DOD (12) | Wild-type (both primary lesion and lung met) |
6 | 22/M | N/A | >2100 | 33 | Neoadjuvant VIP chemo (4 cycles), resection | Mixed GCT (99% mature teratoma with low-grade vascular proliferation, 1% yolk sac tumor) | 22.0 | Stage IIIA (pleural nodule) | NED (1) | Wild-type |
7 | 29/M | Mixed GCT (60% mature teratoma, 30% embryonal and 10% yolk sac tumor) | 3718 | 48.4 | Neoadjuvant VIP chemo (4 cycles x2), resection, HD chemo, metastasectomy | Mature teratoma | 13.2 | Stage IIIA (subcutaneous pectoral nodule) | NED (38) | Wild-type |
8 | 21/M | N/A | 24,610 | N/A | Neoadjuvant VIP chemo (4 cycles), resection | Mature teratoma | 7.8 | Stage I | NED (<1) | Wild-type |
9 | 20/M | Yolk sac tumor | 14,187 | 10 | Neoaduvant VIP chemo (4 cycles), resection | Mature teratoma | 14.5 | Stage I | NED (47) | Wild-type |
10 | 48/M | Yolk sac tumor | 1096 | 110 | Neoadjuvant VIP chemo (4 cycles), resection, adj chemo (2 cycles) | Mixed GCT (95% mature teratoma, 5% yolk sac tumor) | 11.0 | Stage I | NED (1) | Wild-type |
11 | 20/M | N/A | 3311 | 334 | Neoadjuvant BEP chemo (4 cycles), resection | Mature teratoma | 27.0 | Stage IIIA (lung met) | NED (2) | Wild-type |
12 | 34/M | Mixed GCT (yolk sac tumor and mature teratoma) | 11,863 | 7.5 | Neoadjuvant VIP chemo (4 cycles), resection, radiation | Mature teratoma | 18.0 | Stage IIIA (pleural nodules) | NED (71) | Wild-type |
13 | 41/M | N/A | N/A | N/A | Neoadjuvant BEP chemo (4 cycles), resection | Mature teratoma | 11.6 | Stage IIIA (lung met) | NED (24) | IDH2 R172 mutation |
14 | 24/M | Immature teratoma with sarcomatous elements | N/A | N/A | Neoadjuvant chemo, resection | Mature teratoma | 3.5 | Stage I | N/A | Wild-type |
15 | 19/M | N/A | Elevated | N/A | Neoadjuvant BEP chemo, resection | Mixed GCT (yolk sac tumor including hepatoid form and mature teratoma) | 15.4 | Stage I | DOD (2) | Wild-type |
16 | 28/M | Mixed GCT with yolk sac tumor with primitive malignant stroma | N/A | N/A | Neoadjuvant chemo, resection | Adenocarcinoma and primitive pleomorphic sarcoma arising in association with mature teratoma | 12.0 | Stage I | N/A | IDH2 R172 mutation |
17 | 44/M | Yolk sac tumor | N/A | N/A | Neoadjuvant BEP chemo, resection | Mature teratoma | 10.4 | Stage I | DOC, pulmonary injury with bleomycin toxicity (2) | IDH2 R172 mutation |
18 | 22/M | Mixed GCT (80% immature teratoma, 10% embryonal carcinoma, 10% yolk sac tumor) | Elevated | N/A | Neoadjuvant BEP (2 cycles), HD chemo, resection, adj chemo, lung metastasectomy, resection of recurrence with sarcomatous transformation, radiation | Mature teratoma with focal immature elements and highly atypical glial and stromal elements | 25.0 | Stage IIIB (lung, pleural, diaphragm and bone mets) | DOD (216) | Wild-type |
19 | 35/M | Immature teratoma | Elevated | N/A | Neoadjuvant chemo, resection | Mixed GCT (80% mature teratoma with stromal atypia, 15% low grade pleomorphic sarcoma, <5% yolk sac tumor) | 30.0 | Stage IIIA (lung mets) | N/A | Wild-type |
20 | 27/M | N/A | Negative | Negative | Resection | Immature teratoma, grade 1 | 10.8 | Stage I | NED (59) | Wild-type |
