Mixed or Metachronous Germ-cell Tumor?

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2006 Dec 26

PMID 17187270

Citations 5

Authors

Kyu-Won Shim

Dong-Seok Kim

Joong-Uhn Choi

Affiliations

Soon will be listed here.

Abstract

Objective And Importance: We report the extremely rare occurrence of a second germ-cell tumor at a different site and with different histological types long after total resolution of a pineal germinoma.

Clinical Presentation: A 21-year-old man who presented with headache and diplopia was admitted to our hospital. Neuroradiological studies revealed a tumor in the pineal region. The tumor was biopsied with endoscope, and third ventriculostomy was performed. Histologically, the tumor proved to be a germinoma. The patient received 3 cycles of combination chemotherapy consisting of carboplatin and etoposide with radiotherapy. The tumor was totally resolute. Twelve months later, he was readmitted with headache and diplopia. Neuroradiological studies showed a tumor in the right temporal lobe.

Intervention: The second tumor was totally removed. Histologically, the tumor proved to be a mixed germ-cell tumor, which consisted a yolk-sac tumor and a germinoma. After the second course of chemotherapy, magnetic resonance image studies revealed no evidence of the tumor.

Conclusion: The second tumor was considered to be a metachronous neoplasm rather than a recurrence of the original mixed germ-cell tumor, which consisted a yolk-sac tumor and a germinoma.

Citing Articles

Immature teratoma of the posterior cranial fossa in a 4-month-old infant: A case report.

Gao J, Zheng Z Oncol Lett. 2013; 6(1):19-22.

PMID: 23946771 PMC: 3742749. DOI: 10.3892/ol.2013.1325.

Treatment and outcomes of primary intracranial teratoma.

Lee Y, Park E, Park Y, Shim K, Choi J, Kim D Childs Nerv Syst. 2009; 25(12):1581-7.

PMID: 19693515 DOI: 10.1007/s00381-009-0974-8.

Mixed germ cell tumors in septum pellucidum after radiochemotherapy of suprasellar germinoma: de novo metachronous or recurrent neoplasms?.

Eom K, Kim J, Kim T Childs Nerv Syst. 2008; 24(11):1355-9.

PMID: 18560841 DOI: 10.1007/s00381-008-0654-0.

Congenital cavernous sinus cystic teratoma.

Shim K, Kim D, Choi J, Kim S Yonsei Med J. 2007; 48(4):704-10.

PMID: 17722246 PMC: 2628058. DOI: 10.3349/ymj.2007.48.4.704.

The promotion of pediatric neurosurgery throughout the world.

Choi J Childs Nerv Syst. 2007; 23(9):929-36.

PMID: 17593374 DOI: 10.1007/s00381-007-0400-z.

References

Hardenbergh P, Golden J, Billet A, Scott R, Shrieve D, Silver B . Intracranial germinoma: the case for lower dose radiation therapy. Int J Radiat Oncol Biol Phys. 1997; 39(2):419-26. DOI: 10.1016/s0360-3016(97)00330-1. View

Sano K . So-called intracranial germ cell tumours: are they really of germ cell origin?. Br J Neurosurg. 1995; 9(3):391-401. DOI: 10.1080/02688699550041395. View

Sugiyama K, Uozumi T, Kiya K, Mukada K, Arita K, Kurisu K . Intracranial germ-cell tumor with synchronous lesions in the pineal and suprasellar regions: report of six cases and review of the literature. Surg Neurol. 1992; 38(2):114-20. DOI: 10.1016/0090-3019(92)90088-5. View

Shibamoto Y, Sasai K, Oya N, Hiraoka M . Intracranial germinoma: radiation therapy with tumor volume-based dose selection. Radiology. 2001; 218(2):452-6. DOI: 10.1148/radiology.218.2.r01ja08452. View

Ono N, Isobe I, Uki J, Kurihara H, Shimizu T, Kohno K . Recurrence of primary intracranial germinomas after complete response with radiotherapy: recurrence patterns and therapy. Neurosurgery. 1994; 35(4):615-20; discussion 620-1. DOI: 10.1227/00006123-199410000-00006. View

Sugimoto K, Nakahara I, Nishikawa M . Bilateral metachronous germinoma of the basal ganglia occurring long after total removal of a mature pineal teratoma: case report. Neurosurgery. 2002; 50(3):613-6; discussion 616-7. DOI: 10.1097/00006123-200203000-00033. View

Shirato H, Nishio M, Sawamura Y, Myohjin M, Kitahara T, Nishioka T . Analysis of long-term treatment of intracranial germinoma. Int J Radiat Oncol Biol Phys. 1997; 37(3):511-5. DOI: 10.1016/s0360-3016(96)00607-4. View

Jellinger K . Primary intracranial germ cell tumours. Acta Neuropathol. 1973; 25(4):291-306. DOI: 10.1007/BF00691757. View

Hoffman H, Yoshida M, Becker L, HENDRICK E, Humphreys R . Pineal region tumors in childhood. Experience at the Hospital for Sick Children. 1983. Pediatr Neurosurg. 1994; 21(1):91-103; discussion 104. DOI: 10.1159/000120821. View

10.

Jennings M, Gelman R, Hochberg F . Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg. 1985; 63(2):155-67. DOI: 10.3171/jns.1985.63.2.0155. View

11.

Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N . Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg. 1997; 86(3):446-55. DOI: 10.3171/jns.1997.86.3.0446. View

12.

Fuller B, Kapp D, Cox R . Radiation therapy of pineal region tumors: 25 new cases and a review of 208 previously reported cases. Int J Radiat Oncol Biol Phys. 1994; 28(1):229-45. DOI: 10.1016/0360-3016(94)90162-7. View

13.

Ventureyra E, Herder S . Neonatal intracranial teratoma. Case report. J Neurosurg. 1983; 59(5):879-83. DOI: 10.3171/jns.1983.59.5.0879. View

14.

Hollstein M, Sidransky D, Vogelstein B, Harris C . p53 mutations in human cancers. Science. 1991; 253(5015):49-53. DOI: 10.1126/science.1905840. View

15.

Hoffman H, Otsubo H, HENDRICK E, Humphreys R, Drake J, Becker L . Intracranial germ-cell tumors in children. J Neurosurg. 1991; 74(4):545-51. DOI: 10.3171/jns.1991.74.4.0545. View

16.

DeLeo M, Greco F, Hainsworth J, Johnson D . Late recurrences in long-term survivors of germ cell neoplasms. Cancer. 1988; 62(5):985-8. DOI: 10.1002/1097-0142(19880901)62:5<985::aid-cncr2820620524>3.0.co;2-8. View

17.

Haddock M, Schild S, Scheithauer B, Schomberg P . Radiation therapy for histologically confirmed primary central nervous system germinoma. Int J Radiat Oncol Biol Phys. 1997; 38(5):915-23. DOI: 10.1016/s0360-3016(97)00135-1. View

18.

Back M, Hu B, Rutgers J, French S, Moore T . Metastasis of an intracranial germinoma through a ventriculoperitoneal shunt: recurrence as a yolk-sac tumor. Pediatr Surg Int. 1997; 12(1):24-7. DOI: 10.1007/BF01194796. View

19.

Grote E, Lorenz R, VUIA O . Clinical and Endocrinological findings in ectopic pinealoma and spongioblastoma of the hypothalamus. Acta Neurochir (Wien). 1980; 53(1-2):87-98. DOI: 10.1007/BF02074524. View

20.

Carrillo R, Ricoy J, Del Pozo J, Garcia-Uria J, Herrero J . Dissemination with malignant changes from a pineal tumor through the corpus callosum after total removal. Childs Brain. 1977; 3(4):230-7. DOI: 10.1159/000119672. View