Learning objectives
1. Describe the embryological origin of germ cell tumours in various locations.
2.Describe the imaging features for the spectrum of germ cell tumours.
3.Discuss the management of germ cell tumours.
Background
Germ cell tumours most commonly occur in the gonads and are relatively rare in other sites.
Extragonadal sites tend to occur in the midline and include the pineal gland,
neurohypophysis,
mediastinum and retroperitoneum.
Gonadal and extragonadal germ cell tumours are thought to originate from primordial germ cells.
There are varying pathological subtypes of germ cell tumours with a high prevalence of mixed tumours.
This results in varying radiological features,
which can make interpretation difficult.
However,
similar imaging features have been described in pathologically equivalent tumours...
Findings and procedure details
Classification of germ cell tumours
Germ cell tumours (GCTs)affect both gonadal and extragonadal tissue (figure 1).
Histologically they are divided into:
1.Seminomas ( germinoma in pineal gland,
dysgerminoma in ovary)
2.
Nonseminomatous malignant GCTs- embryonal carcinoma,
yolk sac
carcinoma,
choriocarcinoma
3.Teratomas
Embryology of germ cell tumours.
Germ cell tumours (GCTs)are thought to originate from primordial germ cells.
These cells migrate to the primitive gonadal glands in the urogenital ridge.
At the beginning of the 5th gestational week,
primordial gonads appear on the medial side of...
Conclusion
Understanding the radiological findings of the spectrum of germ cell tumours is important to ensure correct diagnosis and management especially as they are potentially curable with aggressive multi modality treatment.
References
1) Ueno et al,
Spectrum of germ cell tumours: from head to toe.
Radiographics volume 24 no.2.
2004.
2) Scully RE,
Young RH,
Clement PB.
Germ cell tumors.
Atlas of tumor pathology: tumors of the ovary,
maldeveloped gonads,
fallopian tube,
and broad ligament,
vol 23,
ser 3.
Washington,
DC: Armed Forces Institute of Pathology,
1998; 239-306.
3) Roasdo-de-Christenson ML,
Templeton PA,
Moran CA.
Meiastinal germ cell tumours:radiologic and pathologic correlatoion.
Radiographics 1992:12:1013-1030.
4)Brammer HM,
Buck JL,
Hayes WS,
Sheth S,
Tavassoli FA.
Malignant germ cell...