Pediatric extragonadal germ cell tumor of the scalp

Extragonadal germ cell tumors are relatively rare tumors, accounting for 5% to 10% of all germ cell tumors in adults. In children, approximately two t hirds of germ cell tumors are extragonadal. Extragonadal germ cell tumor of the scalp is exceedingly rare. The authors report the case of a 1 1/2-year -old boy with extragonadal germ cell tumor over the occipital region. Exami nation of the chest, abdomen, and gonads was normal. Computed tomography sc an of the head showed a large, well-defined, lobulated, heterogeneously enh ancing soft tissue mass lesion in the occipital region. The underlying bone was normal with no evidence of intracranial extension. Biopsy results of t he scalp mass showed features consistent with embroynal carcinoma. Serum al pha-fetoprotein (AFP) level was elevated. The child was started on chemothe rapy and received 4 cycles of cisplatin, etoposide, and bleomycin (PEB). Th ere was more than 90% reduction in the size of the mass at the end of the f ourth cycle. The residual mass was excised and followed up with 2 cycles of postoperative FEB. Ten months after excision the patient is well, without recurrence, and the AFP level is normal. Copyright (C) 2001 by W.B. Saunder s Company.