CYTOLOGY OF GERM-CELL TUMORS - EXTRAGONADAL, EXTRACRANIAL MASSES AND INTRAOPERATIVE PROBLEMS

BACKGROUND. Germ cell tumors (GCTs) and their metastases may be found in numerous sites that are accessible to cytologic sampling, and many are responsive to chemotherapy. METHODS. The authors reviewed 20 examp les of GCT cytology from 16 males and 3 females ranging in age from 1. 5 to 61 years (median, 34 years). With two exceptions, one benign cyst ic ovarian teratoma in which intraoperative cytology was used to diagn ose an associated adult-type carcinoma and one undescended testis in w hich seminoma presented as an abdominal mass, the material reviewed in cluded no examples of primary gonadal GCT. RESULTS. The authors studie d 7 primary and 13 metastatic GCTs; these studies were based on 13 in vivo aspirations, 4 intraoperative preparations, and 3 samples of body cavity fluids. All samples were correctly interpreted as malignant, a nd only one was incorrectly classified as a non-GCT malignancy. CONCLU SIONS. Clinical and cytologic findings are useful in the diagnosis of GCTs and their metastases. Incorrect interpretation of these neoplasms as poorly differentiated malignancies of other types may deprive the patient of effective chemotherapy. Air-dried, Romanowsky-stained smear material and cell block sections may contribute to the resolution of diagnostic dilemmas. (C) 1997 American Cancer Society.