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Extragonadal germ cell tumors are most commonly encountered in the anterior mediastinum. The presence of sarcomatous malignancies in these tumors is a rare phenomenon that adversely impacts patient prognosis because of poor response to conventional cisplatin-based chemotherapy. Even more unusual is the presence of florid benign somatic proliferations that overshadow the germ cell component, often resulting in misdiagnosis and inappropriate management. Two young male patients aged 17 and 28 years respectively presented with mass in the anterior mediastinum. Histopathology of both cases revealed mixed germ cell tumor admixed with prominent vascular component. Interestingly, one case showed malignant vasoformative neoplasm (angiosarcoma) while in the other the vascular proliferation was of benign nature (venous hemangioma).

Vasoformative Lesions in Mediastinal Mixed Germ Cell Tumors: an Interesting Account of Two Cases Spanning the Benign to Malignant Spectrum