Association between germ cell tumor and hematologic maliginities

Asociación entre tumor de células germinales y maliginidades hematológicas

Germ cell tumors represent 2% of human malignancies being more common in men between 15 and 35 years. About 2 to 5% occur extragonadal. Garnik reported the association between hematological malignancies and GCT in 1983, since then several cases have been reported; the majority are presented with non-seminomatous GCTs and hematologic neoplasms of a megakaryocytic nature. They have a poor prognosis and resistance to treatment, most die during the initial management of the diagnosis and there are no optimal protocols for their management. We report a case of hairy cell leukemia (PCL) treated with rituximab with a classical seminoma type GCT managed with platinum protocol (PEB), etoposide and bleomycin, achieving an adequate clinical response. Abbreviations: GCT, germ cell tumor: PCL, hairy cell leukemia.

1. Hartmann JT, Nichols CR, Droz JP, et al. Hematologic disorders associated with primary mediastinal nonseminomatous germ cell tumors. J Natl Cancer Inst. 2000; 92:54-61.

2. Nichols CR, Roth BJ, Heerema N, Griep J, Tricot G. Hematologic neoplasia associated with primary mediastinal germ-cell tumors. N Engl J Med. 1990; 322:1425-9.

3. Ikdahl T, Josefsen D, Jakobsen E, Delabie J, Fosså SD. Concurrent mediastinal germ-cell tumour and haematological malignancy: case report and short review of literature. Acta Oncol. 2008; 47:466-9.

4. Reynoso E, Yau J, Shepherd F, Bailey D, Evans, Baker M. Acute leukemia and mediastinal teratocarcinoma. Proc Am Sue Clin Oncol. 1986; 5: 97.

5. DeMent SH, Eggleston JC, Spivak JL. Association between mediastinal germ cell tumors and hematologic malignancies. Report of two cases and review of the literature. Am J Surg Pathol. 1985; 9: 23-30.

6. Dulmet EM, Macchiarini P, Suc B, Verley JM. Germ cell tumors of the mediastinum. A 30-year experience. Cancer. 1993; 72:1894-901.

7. Garnick MB, Griffin JD. Idiopathic thrombocytopenia in association with extragonadal germ cell cancer. Ann Intern Med. 1983; 98: 926-7.

8. Fanti D, Giudice CR, Truchet C, Damia H, Tejerizo JC, Brugnone R. Tumores Extragonadales. Rev Arg de Urología y Nefrología. 1988; 54(1): 43-4.

9. Heimdal K, Evensen SA, Fosså SD, et al. Karyotyping of a hematologic neoplasia developing shortly after treatment for cerebral extragonadal germ cell tumor. Cancer Genet Cytogenet. 1991; 57: 41-6.

10. Dexeus FH, Logothetis CJ, Chong C, Sella A, Ogden S. Genetic abnormalities in men with germ cell tumors. J Urol. 1988; 140: 80-4.

11. Chaganti RS, Ladanyi M, Samaniego F, Offit K, Reuter VE, Jhanwar SC, et al. Leukemic differentiation of a mediastinal germ cell tumor. Genes Chromosomes Cancer. 1989; 1:83-7.

12. Ladanyi M, Samaniego F, Reuter VE, et al. Cytogenetic and immunohistochemical evidence for the germ cell origin of a subset of acute leukemias associated with mediastinal germ cell tumors. J Natl Cancer Inst. 1990; 82: 221-7.