Patient's question:
Daughter, 1Y9M, on November 18, 2014, discovered an abdominal mass approximately 10 days ago and underwent resection of a retroperitoneal mixed germ cell tumor. The tumor was approximately 10cm x 8cm x 7.6cm. Microscopic description: a cystic and solid mass, with well-differentiated squamous epithelial tissue, neuroglial tissue, and occasional endodermal sinus tumor structures accounting for 40%. Pathological diagnosis: (retroperitoneum) malignant mixed germ cell tumor. Immunohistochemical staining results: Vimentin(+)、AFP(+)、EMA（+）、CK（-)、PLAP(+). Two weeks after surgery, JEB regimen chemotherapy was administered - D1 "Bleomycin (6.5mg) + VP16 (0.035g); D2-4" Carboplatin (90mg) + VP16 (0.035g)". Preoperative AFP was 7000, pre-chemotherapy AFP was 400. Postoperative ultrasound, electrocardiogram, and CT scans: no palpable enlargement of superficial lymph nodes; regular heart rhythm, normal heart sounds, no pathological murmurs; coarse breath sounds in both lungs, no dry or wet rales; soft abdomen, surgical scars visible on the abdominal wall, no redness or tenderness, no significant masses palpable.Doctor's answer:
The staging of tumors depends on whether they have distant metastases. Head MRI with contrast, chest CT, postoperative enhanced CT, bone marrow aspiration, and whole-body bone scan are required for accurate assessment. Chemotherapy typically needs to be continued until alpha-fetoprotein (AFP) levels return to normal, followed by 4 more cycles. The 5-year survival rate is usually around 70%. This type of tumor can be treated with the JEB regimen. The Department of Pediatric Surgery at Shanghai Children's Medical Center is a national clinical key specialty. The Department of Hematologic Oncology is the largest center in China for the diagnosis and treatment of pediatric hematologic diseases, leukemia, malignant solid tumors, and hematopoietic stem cell transplantation, integrating clinical care and research. The National Key Laboratory of Children's Tumor under the Ministry of Health enables more accurate diagnosis and evaluation. However, our hospital's Department of Hematologic Oncology does not accept children who have already undergone chemotherapy at other hospitals.