Synchronous Whole Sternal Metastasis from Primary Malignant Mediastinal Germ Cell Tumor in a Teenager

Primary malignant germ cell tumor (GCT) of the mediastinum is a rare entity with an incidence ranging from 1 to 2% of all childhood cancers. Though a few cases of bone metastasis from mediastinal GCTs have been reported, synchronous whole sternal metastasis from primary malignant mediastinal GCTs is very rare. We report such a rare manifestation in a teenager, emphasizing the need for a multidisciplinary treatment approach with neoadjuvant chemotherapy, surgical expertise for en bloc excision of the mediastinal mass along with whole sternal resection, and reconstruction in a dedicated cancer care center for better oncological outcomes.