Division of Oncology, Department of Pediatrics, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, 4650 Sunset Boulevard, MS#54, Los Angeles, CA 90027, USA.
Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatric Oncology, Children's Cancer and Blood Disorders Center, Children's Hospital Dana-Farber Cancer Center, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
Clin Perinatol. 2021 Mar;48(1):147-165. doi: 10.1016/j.clp.2020.11.010.
Germ cell tumors (GCTs) comprise a wide spectrum of benign and malignant tumors. Neonatal GCTs are predominantly teratomas (mature or immature), which are typically cured with surgery alone. Relapses are infrequent even in the setting of microscopic residual disease; therefore, negative surgical margins at the cost of significant morbidity are not recommended. In neonates with metastatic malignant disease or malignant disease for which upfront surgical resection is not feasible without significant morbidity, an initial biopsy followed by neoadjuvant chemotherapy and delayed surgical resection is recommended. Carboplatin-based regimens should be considered when chemotherapy is indicated.
生殖细胞肿瘤（GCT）包括广泛的良性和恶性肿瘤。新生儿 GCT 主要为畸胎瘤（成熟或不成熟），单独手术即可治愈。即使存在显微镜下残留疾病，复发也很少见；因此，不建议为了获得良好的手术切缘而冒着显著的发病率风险。对于患有转移性恶性疾病或如果不进行显著发病率风险的手术切除就无法进行初始手术切除的恶性疾病的新生儿，建议先进行活检，然后进行新辅助化疗和延迟手术切除。当需要化疗时，应考虑使用卡铂为基础的方案。
