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Many of the tumors that are regarded as malignant in older children may behave in a more benign fashion in the fetus and neonate, including neuroblastoma, congenital myeloproliferative disorder in Trisomy 21, congenital fibrosarcoma, and hereditary retinoblastoma. A number of genetic, chromosomal, and syndromic associations are reported for fetal and neonatal tumors. Germ cell tumors comprise both benign and malignant tumors and can arise in both gonadal and extragonadal locations; the latter are usually found in the midline, including the sacrococcygeal area, mediastinum, and neck. Teratomas contain tissues derived from all three embryonic layers (viz. ectoderm, mesoderm, and endoderm) with a wide range of histological patterns. Neuroblastoma represents a classical embryonal tumor of neuronal lineage that may occur in the adrenal medulla and any other sites of sympathetic ganglia, from the neck to the presacral region.
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