Germ cell tumours usually occur in reproductive cells, but if they affect any other body part, they are extragonadal germ cell tumours (EGGCT). Mediastinal germ cell tumour or mediastinal cancer is a common type of EGGCT. It develops in mediastinum, which is the centre of the chest, which contains the heart, windpipe, food pipe, large main blood vessels and the lymph surrounding the heart. Until now, no known causes are found for the occurrence of mediastinal germ cell tumour.
There are several types of mediastinal germ cell tumour, which are categorised into two main groups- Non-Seminoma Germ Cell Tumours and Seminoma tumour. Non-seminoma group includes mediastinal germ cell tumours such as including teratomas, choriocarcinomas, embryonal carcinomas and yolk sac tumours. Seminoma tumour is one of the most common mediastinal cancers. Last year, well-known Indian cricketer, Yuvraj Singh was diagnosed with mediastinal seminoma cancer.
Usually, this type of tumour is asymptomatic. If symptoms are present, a person may experience shortness of breath, chest pain, cough, high body temperature, sudden weight loss, night sweats, and hoarseness.
Maximum cases of mediastinal malignant germ cell tumours are reported by people, who are between 20 and 35 years of age. In majority of the reported cases, patients are males, but no reason is known for this. It is rarely reported by females and appears to have identical histology and biology to those occurring in males.
There are various diagnostic tests for germ cell tumour, but usually CT scan is undertaken. Other diagnostic tests include chest x-rays, blood tests to measure tumour markers, Mediastinoscopy with biopsy, testicular ultrasound scan to check for potent signs of cancer and Magnetic Resonance Imaging (MRI) of the chest.
Treatment course for mediastinal germ cell tumour depends on its type that the patient is suffering from. The common treatment courses are chemotherapy, radiation therapy and surgery. A combination of these treatments can also be used. Patients of non-seminoma germ cell tumours are usually treated with chemotherapy. The drug combination used in chemotherapy is BEP- bleomycin, etoposide and cisplatin. If chemotherapy fails to remove the cancerous tissue from mediastinum, doctors opt for surgery. In patients with seminoma germ cell tumour, a combination of chemotherapy and radiotherapy is given.
After the completion of cancer treatment, a patient needs to go for regular checkups and tests so as to make sure that there are no recurrent signs of cancer. Tests will include chest X-rays, and blood tests to check for any changes in the level of the tumour markers.
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