Extracranial Germ Cell Tumor in Children: A Three-year Experience of Pediatric Hematology/Oncology Center, Medical City
Abdulaziz ABD1,Salma AL-HADAD2,Hasanein GHALI2,Mazin AL-JADIRY2,Safa FARAJ3,Samaher FADHIL3,Raghad MAJID3
1Department of Pediatrics, College of Medicine, University of Al-Qadisiyah, Al Diwaniyah-Iraq
2Department of Pediatrics, College of Medicine, University of Baghdad, Baghdad-Iraq
3Department of Hemato-oncology, Children Welfare Teaching Hospital, Medical City, Baghdad-Iraq
DOI : 10.5505/tjo.2023.3966 OBJECTIVE
The aim of this study was to describe the clinical, histological, and pathological characteristics in children with GCT and assess their outcome.

This was a retrospective study conducted for children with germ cell tumors who were treated at the Pediatric Hematology-Oncology Center/Medical City for 3 years from January 1st, 2016 to December 31st, 2018, and their follow-up till June 30th, 2021. Thirty-four cases were identified. The total information was collected by using data from the medical record at our oncology registry and from registered archives in outpatient records. Follow-up of patients over an average period of more than 3 years was carried out either in person at the outpatient clinic or by phone call. The Statistical Package for the Social Sciences version 23 was used for analysis.

The initial age of presentation ranged from birth until 14 years. More than sixty percent presented below 4 years of age, and then after this, the age at diagnosis was near equally distributed in both 5-9 years and 10-14 years; 6 and 5 patients (17.6% and 14.7%, respectively). Females predominate in all age groups (76.5%) versus (23.5%) males with a male-to-female ratio of 1: 3.2. The main presenting symptom was fever in 13 (38.3%) patients. There were 11 (32.4%) patients who had testicular swelling, and 11 (32.4%) patients with abdominal distension. The duration of symptoms is more than 6 weeks in 19 (55.9%) cases. The common histological type is a yolk sac tumor in 18 (52.9%) patients. No patients presented with stage I, 9 patients with stage II, 6 (17.7%) patients with stage III, and 9 (26.5%) patients with stage IV. The duration of symptoms is more than 6 weeks in 19 (55.9%) cases. There were four benign cases.

The delayed diagnosis is one of the main obstacles in the management of this group. Risk assessment and staging were not conclusive in some cases due to the gaps between surgeons and oncologists. The upstaging gives better outcome in the overall survival compared to other studies at the same place. Keywords : Children; Iraq; teratoma; yolk sac tumor