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Salomão JFM, Protzenko T. Intracranial Tumors in the First Year of Life. Adv Tech Stand Neurosurg 2023; 46:23-52. [PMID: 37318568 DOI: 10.1007/978-3-031-28202-7_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Intracranial tumors in the first year of life are rare and, in this age group, are the second most common type of pediatric cancer after leukemias. As the more common solid tumor in neonates and infants, they present some peculiarities such as the high incidence of malignancies. Routine ultrasonography made easier to detect intrauterine tumors, but diagnosis can be delayed due to the lack or scarcity of recognizable symptoms. These neoplasms are often very large and highly vascular. Their removal is challenging, and there is a higher rate of morbidity and mortality than seen in older children, adolescents, and adults. They also differ from older children with respect to location, histological features, clinical behavior, and management. Pediatric low-grade gliomas represent 30% of the tumors in this age group and comprise circumscribed and diffuse tumors. They are followed by medulloblastoma and ependymoma. Other non-medulloblastoma embryonal neoplasms, former known as PNETS, are also commonly diagnosed in neonates and infants. Teratomas have an expressive incidence in newborns but decline gradually until the end of the first year of life. Immunohistochemical, molecular, and genomic advances are impacting the understanding and targeting of the treatment of some tumors, but, despite all these advances, the extent of resection remains the most important factor in the prognosis and survival of almost all types of tumors. The outcome is difficult to estimate, and 5-year survival ranges from one-quarter to three-quarters of the patients.
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Affiliation(s)
- José Francisco M Salomão
- Fernandes Figueira Institute - Oswaldo Cruz Foundation (IFF-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Tatiana Protzenko
- Fernandes Figueira Institute - Oswaldo Cruz Foundation (IFF-Fiocruz), Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil
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2
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Luay AA, Htut HT, Huang KG. A Calcified Retroperitoneal Teratoma in a Postmenopausal Woman. J Gynecol Surg 2021. [DOI: 10.1089/gyn.2020.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Abu Atileh Luay
- Department of Obstetrics and Gynecology, Albasheer Hospital, Amman, Jordan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Kweishan, Taoyuan, Taiwan
| | - Hnin Thazin Htut
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Kweishan, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Medicine, Yangon, Myanmar
| | - Kuan-Gen Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Kweishan, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan
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Zhong W, Ma R, Cheng S, Tian J, Wang H, Wang T, Zhang Z, Li X, Lu J, Ma L, Zhou L. Clinical Characteristics and Surgical Management of Adult Adrenal Teratoma: A 15-year Experience and Systematic Review of the Literature. Urology 2019; 135:71-75. [PMID: 31195014 DOI: 10.1016/j.urology.2019.05.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To summarize the clinical characteristics and surgical management of adrenal teratoma in adults. PATIENTS AND METHODS We retrospectively reviewed 14 patients with adrenal teratoma from January 2002 to June 2017, at 2 large centers in China and performed a systematic review of 39 patients from our series and published literatures. The clinicopathological characteristics, imaging features, surgical management and outcomes of this rare disease were analyzed. RESULTS Our series includes 12 females and 2 males with the median age of 35. Seven patients were treated by open adrenalectomy (OA) and 7 by laparoscopic adrenalectomy (LA) without perioperative complications. All patients were alive without recurrence or canceration over a mean follow-up of 77.1 months. In the systemic review, the male-female ratio was nearly 1:3, with a median age of 29 years. Mean tumor size was 9.4 cm and the distribution was almost the same between left and right side (53.8% vs 46.2%). The most common symptoms were flank or abdominal pain (46.2%), whereas 53.8% patients were asymptomatic. Tumors were often cystic (63.9%) with intratumoral fat (91.7%) and calcifications (80.6%). All patients underwent surgery including 17 (43.6%) OA and 22 (56.4%) minimally invasive surgery. All tumors were pathologically confirmed mature teratoma except for one. CONCLUSION Adrenal teratoma is an extremely rare entity, frequently found to be large, benign and cystic. The patient's prognosis is generally good. As for its large volume, OA is the first choice for teratoma in most cases, while the LA can be an option in the small one.
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Affiliation(s)
- Wenlong Zhong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China; Department of Urology, Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Runzhuo Ma
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Sida Cheng
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Jie Tian
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - He Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Tianyu Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Zheng Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Jian Lu
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Lulin Ma
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
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Hong W, Dumoff KL, Torigian DA, Bing Z. Primary retroperitoneal mature cystic teratoma with focal enteric type adenocarcinoma in a post-partum woman: report of a case with literature review. Rare Tumors 2013; 5:e1. [PMID: 23772296 PMCID: PMC3682448 DOI: 10.4081/rt.2013.e1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 11/10/2012] [Indexed: 02/07/2023] Open
Abstract
Teratomas are characterized by containing tissue from all three germinal cell layers. Occasionally, somatic type malignancies develop within a mature cystic teratoma. We reported here a rare case of enteric type adenocarcinoma, with associated dysplastic epithelial precursor lesion, arising within a mature cystic teratoma in the retroperitoneum of a 30-year-old woman status post vaginal delivery 11 weeks earlier. The mass is 17.5 cm and cystic. A polypoid mass component measuring 4.7×4.2×2.5 cm was located inside the cystic component. Microscopically, the majority of the specimen was a mature cystic teratoma with all three germinal cell layers. The polypoid mass component was an adenocarcinoma with an adjacent dysplastic epithelial precursor lesion. The adenocarcinoma was diffusely positive for CK20 and CDX-2, and focally positive for CD7, indicating enteric differentiation. A brief review of retroperitoneal mature cystic teratomas with associated somatic type malignancy was performed.
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Affiliation(s)
- Wei Hong
- Department of Pathology and Laboratory Medicine, Conemaugh Memorial Medical Center, Johnstown, PA
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Abstract
Congenital brain tumors are rare, accounting for 0.5% to 4% of all pediatric brain tumors. A 10-year retrospective study based on autopsy and neurosurgical clinical reports with a diagnosis of congenital/fetal/neonatal brain tumor identified 6 cases. Four cases were diagnosed antenatally by neuroradiology. Clinical outcomes in 5 cases resulted in death; 1 patient with choroid plexus papilloma underwent successful resection of the tumor and is still alive. Tumor pathologies consisted of 2 teratomas, 2 choroid plexus papillomas, 1 gemistocytic astrocytoma, and 1 glioblastoma multiforme. A literature review of all fetal cases specific to the pathologies presented in this series was also performed. Relative to the literature, this series contains a rare case of congenital gemistocytic astrocytoma. This series further sheds light on the diagnostic, histological, prognostic, and therapeutic differences between congenital brain tumors and tumors of the same pathology in older pediatric and adult populations.
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Affiliation(s)
- Branavan Manoranjan
- Department of Pathology and Molecular Medicine, Hamilton General Hospital, McMaster University, Hamilton, ON, Canada
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Wagner H, Baretton GB, Schneiderbanger K, Nerlich A, Bise K, Löhrs U. Sex Chromosome Determination in Extragonadal Teratomas by Interphase Cytogenetics: Clues to Histogenesis. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/15513819709168583] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gatcombe HG, Assikis V, Kooby D, Johnstone PAS. Primary retroperitoneal teratomas: a review of the literature. J Surg Oncol 2004; 86:107-13. [PMID: 15112254 DOI: 10.1002/jso.20043] [Citation(s) in RCA: 155] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Teratomas are uncommon neoplasms comprised of mixed dermal elements derived from the three germ cell layers. Historically, teratomas were attributed to demons, sexual misconduct, and abnormal fertilization. They attract attention because of their bizarre histology and gross appearance. While the majority of teratomas present congenitally in the sacrococcygeal region, within the ovaries of adolescent females and within the testes of young men, they have been identified throughout the body. Extragonadal teratomas tend to occur in midline structures as the anterior mediastinum, retroperitoneum, sacrococcygeal region, and pineal gland. Retroperitoneal teratomas represent only 1-11% of primary retroperitoneal tumors. Incidence is bimodal with peaks in the first 6 months of life and in early adulthood. Due to their location, they are usually identified only after they have grown to huge proportions. There is a 25% chance of malignancy. Surgical resection remains the mainstay of therapy and is required for definitive diagnosis. This article reviews the literature on the histopathology, classification, genetic abnormalities, and theories of origin of teratomas as well as the presentation, diagnosis, and management of retroperitoneal teratomas.
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Affiliation(s)
- Heather G Gatcombe
- Radiation Oncology Department, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Im SH, Wang KC, Kim SK, Lee YH, Chi JG, Cho BK. Congenital intracranial teratoma: prenatal diagnosis and postnatal successful resection. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 40:57-61. [PMID: 12426690 DOI: 10.1002/mpo.1351] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- So-Hyang Im
- Department of Neurosurgery and Laboratory for Fetal Medicine Research in Clinical Research Institute, Seoul National University Hospital, Korea
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Abstract
Central nervous system tumors occur considerably less often in the fetus and neonate than in the older child. These tumors are not entirely the same as those found later in life. Their location, biologic behavior, response to therapy, and histologic types are different. Reports of 250 fetal and neonatal brain tumors were collected from the literature and studied for this review. The overall survival rate was 28%. The entire cranial cavity may be filled with tumor, and stillbirth is not uncommon. Macrocephaly was the most frequent presentation regardless of histology. Outcome is related to the size and location of the tumor, the histologic type, surgical resectability, and the condition of the infant at the time of diagnosis. Neonates with choroid plexus papillomas, gangliogliomas, and low-grade astrocytomas have the best prognosis, whereas those with teratomas and primitive neuroectodermal tumors have the worst prognosis.
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Affiliation(s)
- Hart Isaacs
- Department of Pathology, Children's Hospital San Diego, California 92123, USA
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Williams BH, Yantis LD, Craig SL, Geske RS, Li X, Nye R. Adrenal teratoma in four domestic ferrets (Mustela putorius furo). Vet Pathol 2001; 38:328-31. [PMID: 11355665 DOI: 10.1354/vp.38-3-328] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Teratomas are histologically complex neoplasms that are composed of structures derived from multiple germ cell layers (ectoderm, mesoderm, and endoderm). These neoplasms are uncommon in domestic animals and are usually found in the gonads. This paper describes teratomas of the adrenal gland in four domestic ferrets (Mustela putorius furo). Three of four of the neoplasms contained tissues from ectodermal, mesodermal, and endodermal germ cell layers; two of four contained rudimentary teeth. In one case, malignant epithelial cells had metastasized to local lymph nodes. Teratomas, although uncommon, should be included in the differential diagnosis for adrenal neoplasms in domestic ferrets.
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Affiliation(s)
- B H Williams
- Department of Telemedicine, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
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Kruslin B, Visnjić A, Cizmic A, Tomicić I, Kos M, Jukić S, Seiwerth S. DNA ploidy analysis and cell proliferation in congenital sacrococcygeal teratomas. Cancer 2000; 89:932-7. [PMID: 10951360 DOI: 10.1002/1097-0142(20000815)89:4<932::aid-cncr29>3.0.co;2-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Congenital sacrococcygeal teratoma is the most common germ cell tumor in infants and children. It usually is diagnosed at birth, is benign, and consists of fully differentiated mature tissues. Congenital sacrococcygeal teratomas (SCTs) also may contain immature tissues, most commonly of neural origin. The proportion of malignant teratomas increases with advancing age, but the relation between mature and immature SCTs is not well understood. Thus, it is very important to determine proliferative activity, DNA ploidy, and DNA index to predict biologic behavior of these tumors. METHODS DNA ploidy and cell proliferation were analyzed by flow cytometry, and the expression of proliferating cell nuclear antigen (PCNA) and Ki-67 were analyzed immunohistochemically on paraffin embedded tissue. RESULTS All the tumors that were surgically treated within 3 months after birth, including immature teratoma, were diploid. Strongly positive PCNA immunostaining was found in both immature teratomas, and weakly positive PCNA was found in nine cases. Weak positivity for Ki-67 was observed in 2 cases, and moderate positivity was observed in 6 cases including immature teratomas. CONCLUSION The value of flow cytometry in the prediction of biologic behavior of congenital SCT should be analyzed further. Our results suggest that Ki-67 and especially PCNA may reflect the proliferative activity of these tumors.
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Affiliation(s)
- B Kruslin
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
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12
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Soares FA, Fischer SE, Reis MA, Soares EG. Massive intracranial immature teratoma. Report of a case with polyhidramnios and intense pelvic pain. ARQUIVOS DE NEURO-PSIQUIATRIA 1996; 54:309-12. [PMID: 8984992 DOI: 10.1590/s0004-282x1996000200021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A case of massive intracranial immature teratoma in a female stillborn is reported. She was the product of the second pregnancy of a 25-year-old healthy woman. The pregnancy was unremarkable until the 25th week of gestation when the mother noticed a rapid enlargement of her abdomen and intense pelvic pain. Because of the pain, a cesarean section was indicated, and a stillborn weighing 2750g with macrocephaly was delivered. The cranial contents weighed 1350g and showed a huge tumoral mass with only a rim of normal brain. A histologic diagnosis of immature teratoma was made. Massive intracranial teratomas are rare tumors and their occurrence in intrauterine life is even rarer. Their histogenesis is unknown, and there is no explanation for their continuous growth during embryogenesis. A prenatal diagnosis of this rare condition can be made by ultrasound, computed tomography, or magnetic resonance imaging.
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Affiliation(s)
- F A Soares
- Department of Pathology, University of São Paulo, Brazil.
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13
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Garrè ML, El‐Hossainy MO, Fondelli P, Göbel U, Brisigotti M, Donati PT, Nantron M, Ravegnani M, Garaventa A, De Bernardi B. Is chemotherapy effective therapy for intracranial immature teratoma?: A case report. Cancer 1996. [DOI: 10.1002/(sici)1097-0142(19960301)77:5<977::aid-cncr26>3.0.co;2-#] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maria L. Garrè
- Division of Pediatric Hematology‐Oncology, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Mohamed Omar El‐Hossainy
- Division of Pediatric Hematology‐Oncology, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Paola Fondelli
- Neuroradiology Department, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Ulrich Göbel
- Department of Pediatric Hematologie and Oncologie, Heinrich‐Heine‐University, Düsseldorf, Germany
| | | | - Paolo Tortori Donati
- Neuroradiology Department, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Marilina Nantron
- Division of Pediatric Hematology‐Oncology, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Marcello Ravegnani
- Neurosurgery Department, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Alberto Garaventa
- Division of Pediatric Hematology‐Oncology, Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | - Bruno De Bernardi
- Division of Pediatric Hematology‐Oncology, Giannina Gaslini Children's Research Hospital, Genoa, Italy
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Naudin ten Cate L, Vermeij-Keers C, Smit DA, Cohen-Overbeek TE, Gerssen-Schoorl KB, Dijkhuizen T. Intracranial teratoma with multiple fetuses: pre- and post-natal appearance. Hum Pathol 1995; 26:804-7. [PMID: 7628856 DOI: 10.1016/0046-8177(95)90232-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
An intracranial teratoma in which six distinct dysmorphic fetuses were included was studied at autopsy. Karyotopic studies showed a normal chromosomal number in the child and the same karyotype in the three tumoral parts were examined. This is the second tumor of this type reported.
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Affiliation(s)
- L Naudin ten Cate
- Department of Pathology, Regional Laboratory of Pathology and Microbiology, Enschede, The Netherlands
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Hoffner L, Deka R, Chakravarti A, Surti U. Cytogenetics and origins of pediatric germ cell tumors. CANCER GENETICS AND CYTOGENETICS 1994; 74:54-8. [PMID: 8194048 DOI: 10.1016/0165-4608(94)90029-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We present cytogenetic and DNA fingerprint analysis on 13 new cases of pediatric germ cell tumors; we analyze further four cases we have reported previously. The patients ranged in age from 23 weeks gestation to 16 years. The tumors were located in the ovary, sacrococcygeum, testis, mediastinum, and the craniofacial region, and represented benign, immature, and malignant cases. All of the new cases had a normal diploid karyotype. We have previously reported on multiple genetic mechanisms of origin for ovarian germ cell tumors, namely meiosis I nondisjunction, meiosis II nondisjunction, endoreduplication of a haploid ovum, mitotic division of premeiotic germ cell, and fusion of two ova. To determine the origin of extragonadal and testicular GCTs, Q-band centromeric heteromorphisms and DNA markers were analyzed in the host and the cognate tumor. Our data suggest that extragonadal and testicular GCTs do not arise by a meiosis I or II error, or by endoreduplication; rather, they arise mitotically from either a somatic or a germ cell.
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Affiliation(s)
- L Hoffner
- Department of Pathology, Magee-Womens Hospital, Pittsburgh, PA 15213
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