His association of mediastinal germ-cell tumours (MGCTs) with haematologic neoplasms is a rare though well known circumstance, and few cases are found in the literature. Most of these are non-seminomatous tumours in young males. The diagnosis of the haematological condition is usually either synchronic or metachronic with that of the germ-cell tumour. The prognosis is poor and basically determined by the haematologic neoplasia. Less than 20 cases of PMGCT with evolution into acute megakaryocytic leukemia have been reported in worldwide literature. Hematologic neoplasias associated with extragonadal germ cell tumors represent one of the most intriguing and biologically distinctive aspects of male germ cell cancers. The case report we present is that of a young 33 year old male with an initial diagnosis of both conditions which were detected synchronously. Despite timely intervention he succumbed to multiorgan failure following chemotherapy and an autopsy was performed.