Unusual imaging findings associated with abdominal pediatric germ cell tumors

• Published in: Pediatric radiology 2024-06, Vol.54 (7), p.1093-1104
• Main Authors: Gagnon, Marie-Helene, Derenoncourt, Paul-Robert, Rayamahi, Sampanna, Taylor, Susan, Parikh, Ashishkumar K., Ponisio, Maria R., Khanna, Geetika
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Neoplasms - diagnostic imaging; Adolescent; Antibodies; Autoimmune diseases; Child; Child, Preschool; Children; Diagnostic Imaging - methods; Encephalitis; Female; Glutamate receptors; Humans; Hyperthyroidism; Imaging; Male; Mediastinum; Medicine; Medicine & Public Health; Metastases; Metastasis; N-Methyl-D-aspartic acid receptors; Neoplasms, Germ Cell and Embryonal - diagnostic imaging; Neuroradiology; Nuclear Medicine; Oncology; Paraneoplastic syndrome; Pediatrics; Pelvis; Pictorial Essay; Puberty; Radiology; Retroperitoneum; Teratoma; Tumors; Ultrasound
• ISSN: 1432-1998; 0301-0449; 1432-1998
• DOI: 10.1007/s00247-024-05894-9

Germ cell tumors of childhood are tumors arising from germline cells in gonadal or extragonadal locations. Extragonadal germ cell tumors are characteristically located in the midline, arising intracranially or in the mediastinum, retroperitoneum, or pelvis. These tumors are generally easily diagnosed due to typical sites of origin, characteristic imaging findings, and laboratory markers. However, germ cell tumors can be associated with unusual clinical syndromes or imaging features that can perplex the radiologist. This review will illustrate atypical imaging/clinical manifestations and complications of abdominal germ cell tumors in childhood. These features include unusual primary tumors such as multifocal primaries; local complications such as ovarian torsion or ruptured dermoid; atypical presentations of metastatic disease associated with burned-out primary tumor, growing teratoma syndrome, and gliomatosis peritonei; endocrine manifestations such as precocious puberty and hyperthyroidism; and antibody mediated paraneoplastic syndrome such as anti-N-methyl-D-aspartate-receptor antibody-mediated encephalitis. This review aims to illustrate unusual imaging features associated with the primary tumor, metastatic disease, or distant complications of abdominal germ cell tumors of childhood. Graphical abstract