{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:38:31Z","timestamp":1788629911657,"version":"build-2803163510"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Germ cell tumors in infants are most frequently extragonadal, benign, and amenable to surgical resection. An unusual feature of germ cell tumors is the potential coexistence of malignant with benign disease which makes it possible for patients with incompletely resected tumors to experience either a benign or malignant recurrence. A challenge to postoperative surveillance is the interpretation of serum alpha fetoprotein, a marker of malignancy, that is physiologically elevated during the first year of life. A rare subset of germ cell tumors occur in the retroperitoneum. Although the vast majority are benign, these tumors are often large and distort normal anatomy, and may demonstrate local invasiveness that increases risk of resection. The intent of these reports is to caution readers about these unusual features of germ cell tumors of infancy.<\/jats:p>","DOI":"10.3389\/fped.2021.659083","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T04:38:45Z","timestamp":1618461525000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Case Reports: Management Challenges in Pediatric Germ Cell Tumors"],"prefix":"10.3389","volume":"9","author":[{"given":"Sophie","family":"Carr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Safavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik D.","family":"Skarsgard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1016\/j.juro.2014.05.118","article-title":"Management of germ cell tumors with somatic type malignancy: pathological features, prognostic factors and survival outcomes","volume":"192","author":"Rice","year":"2014","journal-title":"J Urol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1053\/j.sempedsurg.2011.10.005","article-title":"Pediatric germ cell tumors","volume":"21","author":"Rescorla","year":"2012","journal-title":"Semin Pediatr Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1002\/jso.20043","article-title":"Primary retroperitoneal teratomas: a review of the literature","volume":"86","author":"Gatcombe","year":"2004","journal-title":"J Surg Oncol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"135","DOI":"10.3109\/08880019809167228","article-title":"Alpha 1-fetoprotein (AFP) reference values in infants up to 2 years of age","volume":"15","author":"Blohm","year":"1998","journal-title":"Pediatr Hematol Oncol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1200\/JCO.1999.17.7.2137","article-title":"Complete surgical excision is effective treatment for children with immature teratomas with or without malignant elements: a Pediatric Oncology Group\/Children's Cancer Group Intergroup Study","volume":"17","author":"Marina","year":"1999","journal-title":"J Clin Oncol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jpedsurg.2005.10.022","article-title":"Study of the factors associated with recurrence in children with sacrococcygeal teratoma","volume":"41","author":"De Backer","year":"2006","journal-title":"J Pediatr Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"103140","DOI":"10.1016\/j.critrevonc.2020.103140","article-title":"Malignant recurrence after mature Sacrococcygeal teratoma: a meta-analysis and review of the literature","volume":"156","author":"Kops","year":"2020","journal-title":"Crit Rev Oncol Hematol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1097\/00000478-199809000-00011","article-title":"Immature teratomas in children: pathologic considerations: a report from the combined Pediatric Oncology Group\/Children's Cancer Group","volume":"22","author":"Heifetz","year":"1998","journal-title":"Am J Surg Pathol."},{"key":"B9","first-page":"406","article-title":"Occult malignancy in neonatal sacrococcygeal teratomas. 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