Late Relapse

Patients with late recurrence of germ cell tumor have a unique biologic profile and behavior. The patients frequently have elevated AFP as the associated serum biomarker and frequently have characteristic histopathologic findings of yolk sac tumor. The malignant germ cell elements tend to be much more resistant to chemotherapy than are de novo germ cell tumors.

The prognosis for the small subset of patients who experience late recurrence of germ cell tumor

(more than 2 years beyond initial treatment) is tied largely to the histologic composition of the late recurrent disease. For those with recurrent teratoma, the overall prognosis for aggressive resection undertaken by an experienced surgeon is good. Resection is likewise a primary consideration for those patients with recurrent germ cell elements or malignant non-germ cell elements.

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