Occurrence of malignant non-germ cell components in primary mediastinal germ cell tumours

Methods: Thirty-five patients with primary mediastinal germ cell tumours (P MGCT) underwent primary thoracotomy in a 30-year period (1965-1994). Of the 35 patients, 12 had benign teratomas, five pure seminomas and 18 non-semin omatous germ cell tumours. Results: Out of 18 non-seminomatous germ cell tumours, 14 comprised more th an one malignant component. In two cases malignant teratomas had an additio nal malignant non-germ cell component: one a mixed sarcomatous component an d the other a neuroendocrinal component. There were different methods of treatment between 1965 and 1994. All but on e of patients with seminomas survived fur 5 years. Among 18 patients with m alignant PMGCT, all but two died within 5 years (mean survival rate was 15 months). Conclusions: When planning treatment of patients with malignant PMGCT we ha ve to take into account the fact that malignant non-germ-cell components ma y occur. in this circumstances, surgical resection after initial chemothera py is recommended.