Primary mediastinal germ cell tumors

Thirty patients with germ cell tumors originating in the mediastinum are reviewed and analyzed (20 embryonal carcinomas and 10 seminomas). Local control of the disease was successful by resection and/or external radiation in patients with seminoma; 50% were alive and well at 10 years. Patients with embryonal carcinoma were poorly controlled with surgery, radiation, or chemotherapy. However, early aggressive chemotherapy did seem to improve survival in embryonal carcinoma. Death by local recurrence was characteristic of embryonal carcinoma, whereas distant spread of disease, usually to bone and lymph nodes, was the cause of death in seminoma.