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Multicenter Study
. 2025 Jul;72(7):e31747.
doi: 10.1002/pbc.31747. Epub 2025 May 1.

Pediatric Head and Neck Germ Cell Tumors: Current Management and Risk of Malignant Transformation

Estelle Hadjean  1 , Matthieu Carton  2 , Vincent Couloigner  3 , Romain Luscan  3 , Thierry Van Den Abbeele  4 , Natacha Teissier  4 , Cecile Faure-Conter  5 , Brice Fresneau  6 , Guillaume Morcrette  7 , Brigitte Lacour  8   9 , Jacqueline Clavel  8   9 , Emmanuel Desandes  8   9 , Coralie Mallebranche  10 , Michel Mondain  11 , Liana Carausu  12 , Pierre Fayoux  13 , Cecile Dumesnil  14 , Cecile Boulanger  15 , Cecile Vérité  16 , Judith Landman-Parker  17 , Helene Sudour-Bonnange  18 , Rémi Marianowski  19 , Nicolas Leboulanger  20 , Dominique Plantaz  21 , Sonia Ayari  22 , Mohamed Akkari  11 , Thomas Sagardoy  23 , Marie-Noelle Calmels  24 , Daniel Orbach  1
Affiliations
Multicenter Study

Pediatric Head and Neck Germ Cell Tumors: Current Management and Risk of Malignant Transformation

Estelle Hadjean et al. Pediatr Blood Cancer. 2025 Jul.

Abstract

Background and aims: Head and neck germ cell tumors (HN-GCTs), excluding the central nervous system, are rare and frequently contain mature or immature teratoma (MIT) compounds. The aims of this study were to analyze the risk of malignant transformation after MIT HN-GCTs, to describe treatments and sequelae, and to propose recommendations for the follow up of these patients.

Methods: National multicentric retrospective study of all patients aged from birth to 17 years, treated in France between 2000 and 2021 for a HN-GCT of all histotypes. Patients were selected from various sources: French National Registry of Childhood Cancers, SFCE (Société Française des Cancers de l'Enfant) centers and pediatric ENT (ear, nose and throat) surgical centers.

Results: A total of 152 patients were selected. Median age at diagnosis was 9 months (range, 0-190), with 34 diagnosed antenatally. Overall, 150 tumors contained MIT and two were malignant yolk sac GCT (YST). All patients, except for two cases with early postpartum death, underwent surgery, preceded in 12 cases by an EXIT (Ex Utero Intra Partum) procedure. After a median follow-up of 47 months (range, 11-124), four patients with MIT developed a localized mature teratoma relapse, three developed a localized secreting malignant HN-GCT (including two malignant degenerations after MIT), and one had a thoracic neuroblastoma. All patients survived. 9% of survivors developed moderate to severe sequelae.

Conclusions: Due to the low rate of malignant degeneration (two out of 148, 1.3%), this study does not support systematic oncologic long-term monitoring after neonatal MIT HN-GCT. However, regular clinical examination is required to detect and treat locoregional sequelae.

Keywords: germ cell tumors; head and neck; immature teratoma; infants; malignant transformation.

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