TY - JOUR
T1 - Surgical challenges of excision of retroperitoneal germ cell tumors in children
T2 - a single institutional study with literature review
AU - Bollemeijer, Juliette F.
AU - Mavinkurve-Groothuis, Annelies M.C.
AU - Kooij, Cezanne D.
AU - Zsiros, József
AU - Littooij, Annemieke S.
AU - van der Steeg, Alida F.W.
AU - Wijnen, Marc H.W.A.
AU - Hulsker, Caroline C.C.
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Retroperitoneal germ cell tumors (GCTs) are rare, commonly large tumors, often diagnosed in infancy. Complete surgical resection may pose a serious challenge as encasement of major vessels and organ displacement can lead to perioperative complications. This study aims to illustrate the surgical challenges of excising retroperitoneal GCTs. Results: Nine patients were included: six patients with a teratoma, two patients with a mixed GCT with a yolk sac tumor component, and one patient with a pure yolk sac tumor. Six were males and seven were younger than 1 year of age at time of presentation. In all cases, perioperative vascular or organ-related complications occurred in one patient; this resulted in short bowel syndrome. There was no recurrence or mortality during the follow-up period. Relevant literature is reviewed and described. Conclusions: The anatomical relation of a retroperitoneal GCT to the major vessels and organs is unpredictable. Preoperative radiological evaluation can help to improve the understanding of the vascular anatomy and to plan accordingly. Anteriorly displaced veins may appear insignificant and arteries, such as the superior mesenteric artery may be encased. Preoperative imaging may prevent perioperative complications, leading to safer surgical procedures.
AB - Background: Retroperitoneal germ cell tumors (GCTs) are rare, commonly large tumors, often diagnosed in infancy. Complete surgical resection may pose a serious challenge as encasement of major vessels and organ displacement can lead to perioperative complications. This study aims to illustrate the surgical challenges of excising retroperitoneal GCTs. Results: Nine patients were included: six patients with a teratoma, two patients with a mixed GCT with a yolk sac tumor component, and one patient with a pure yolk sac tumor. Six were males and seven were younger than 1 year of age at time of presentation. In all cases, perioperative vascular or organ-related complications occurred in one patient; this resulted in short bowel syndrome. There was no recurrence or mortality during the follow-up period. Relevant literature is reviewed and described. Conclusions: The anatomical relation of a retroperitoneal GCT to the major vessels and organs is unpredictable. Preoperative radiological evaluation can help to improve the understanding of the vascular anatomy and to plan accordingly. Anteriorly displaced veins may appear insignificant and arteries, such as the superior mesenteric artery may be encased. Preoperative imaging may prevent perioperative complications, leading to safer surgical procedures.
KW - Germ cell tumor
KW - Pediatric
KW - Retroperitoneum
KW - Surgery
KW - Teratoma
UR - http://www.scopus.com/inward/record.url?scp=85107323779&partnerID=8YFLogxK
U2 - 10.1186/s43159-021-00086-8
DO - 10.1186/s43159-021-00086-8
M3 - Article
AN - SCOPUS:85107323779
SN - 1687-4137
VL - 17
JO - Annals of Pediatric Surgery
JF - Annals of Pediatric Surgery
IS - 1
M1 - 20
ER -