Weidner N
Department of Pathology, University of California, San Francisco 94143, USA.
Semin Diagn Pathol. 1999 Feb;16(1):42-50.
Mediastinal germ-cell tumors (GCTs) usually occur within the anterior mediastinum, accounting for about 15% of all mediastinal cysts and tumors. They are associated with the thymus, presumably arising from extragonadal germ cells or thymic cells with germ-cell potential. Mediastinal seminoma develops primarily in young males with rare cases reported in females; likewise, embryonal carcinoma, endodermal sinus tumor or yolk-sac tumor, choriocarcinoma, and malignant mixed or combined GCTs also overwhelmingly affect males. Mature cystic teratoma affects males and females equally. The prognosis for mediastinal mature cystic teratoma and seminoma is very good. Nonseminomatous malignant GCTs of the mediastinum often present with advanced disease and do not respond as well to chemotherapy as their gonadal counterparts. Nonetheless, it is important to separate mediastinal GCTs from other undifferentiated malignant tumors, especially thymic carcinoma, which has a poor prognosis. Clearly, some patients with mediastinal GCTs respond very well to modern therapies.
纵隔生殖细胞肿瘤（GCTs）通常发生在前纵隔，约占所有纵隔囊肿和肿瘤的15%。它们与胸腺有关，可能起源于性腺外生殖细胞或具有生殖细胞潜能的胸腺细胞。纵隔精原细胞瘤主要发生于年轻男性，女性病例罕见；同样，胚胎癌、内胚窦瘤或卵黄囊瘤、绒毛膜癌以及恶性混合性或复合型GCTs也绝大多数累及男性。成熟囊性畸胎瘤对男性和女性的影响相同。纵隔成熟囊性畸胎瘤和精原细胞瘤的预后非常好。纵隔非精原细胞性恶性GCTs常表现为晚期疾病，对化疗的反应不如性腺来源的同类肿瘤。尽管如此，将纵隔GCTs与其他未分化恶性肿瘤，尤其是预后较差的胸腺癌区分开来很重要。显然，一些纵隔GCTs患者对现代疗法反应良好。
