Abstract
Germ cells tumors most frequently occur in the gonads. Extra gonadal localization is rare and occurs mainly in the mediastinum, retro peritoneum and pineal gland. There are case reports and case series in children of primary head and neck region mixed germ cell tumors. These are even rarer in adults. We present a rare case of an adult patient with a mixed germ cell tumor located primarily in the head and neck region diagnosed after a complete neck dissection. A 40 years old male presented with left sided submandibular swelling and bleeding per mouth. Initial biopsy revealed mucoepidermoid carcinoma but final histopathology reported mixed germ cell tumor after complete left neck dissection. There was no residual disease on the post-operative scans. He was treated with two lines of chemotherapy regimens followed by palliative radiotherapy with some clinical benefit. He is currently on active surveillance.

Key words: Adult, Extra gonadal, Germ cell tumors, Head and neck region