Successful Treatment Outcome of a Pediatric Malignant Germ Cell Tumor With an Extensive Cavo-atrial Tumor Thrombus Presenting as an Oncological Emergency.

Background: Pediatric germ cell tumor (GCT) with extensive cavo-atrial tumor thrombus presenting as an oncologic emergency is extremely rare.

Observation: A 13-month-old female child with sacrococcygeal GCT having inferior vena cava (IVC) and right atrial thrombus presenting with anasarca and respiratory distress is reported. Because of worsening symptoms post initiation of chemotherapy, tumor thrombus debulking from the right atrium and distal end of IVC was performed on day 9 on an emergency basis. Her symptoms improved, and after planned chemotherapy, tumor excision with coccygectomy could be done. The IVC thrombus remained inoperable due to sclerosis. She remains recurrent-free now 12 months post therapy.