This study was designed to evaluate the characteristics of malignant germ cell tumors (MGCT) in pediatric patients. Medical records of 71 children who had MGCT from 1985 to 1994 were reviewed. The mean age was six years and the sex ratio (male:
female)
was 3:4. According to the histologic classification, the most common MGCT was malignant teratoma and the next most common was endodermal sinus tumor. Malignant teratoma, endodermal sinus tumor and embryonal carcinoma appeared to be more commonly
in
the
younger age group. The clinical presentations varied and depended on the primary site. Thirty-nine cases of MGCT originated from the gonads and the other thirty-to case were extragonadal tumors. All of the dysgerminoma and gonadal mixed germ cell
tumors
developed from the ovaries; however, all of the gonadal embryonal carcinomas developed from the testes. Preoperative levels of serum α-fetoprotein (AFP) were significantly increased in all of he endodermal sinus tumors, the embryonal carcinomas,
the
mixed germ cell tumors and in 69% of the malignant teratomas. Serum β-human chorionic gonadotropin (β-HCG) were increased in all of the choriocarcinomas, in 83% of the dysgerminomas and in 11% of the malignant teratoma. Malignant teratoma had
the
best
prognosis. Although the MGCTs were rare in the pediatric age group and their histologic subtypes were variable, each tumor had specific characteristics according to histologic classification, the age of onset, the primary site and the secreting
tumor
markers. Therefore, these specific features should be considered the diagnosis and management of MGCT in children.
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