A rare case of extramedullary spinal cord germinoma

Abstract

A rare case of spinal cord germinoma in a 20-year-old Japanese female is presented. The tumor was detected at the level of T11 and L3 by myelography. Histological findings of the resected tumor were identical to germinoma, which is characterized by polygonal tumor cells, lymphocytic infiltrate, and granuloma. Tumor cells and lymphocytes reacted with antibodies for placental alkaline phosphatase and CD45, respectively. A few multinucleated giant cells, negative immunohistochemically for human chorionic gonadotropin were also seen. The present case is the 10th case of spinal cord germinoma and is thought to be the first case of such a tumor located extramedullary. Diagnosis of such a rare tumor in an unusual location needs proper histological, ultrastructural and immunohistochemical evaluation.

MR Imaging of Primary Spinal Germinoma: A Case Report and Review of the Literature

“…Nonetheless, the conus medullaris was seemed to be the often origin site of extramedullary presentation. With regard to the histogenesis, primary extragonadal germinomas occur as midline structures in the retroperitoneum, mediastinum, and the brain, all along the path of the primordial germ cells migration 2, 5 . In our case, the tumor was located in the extramedullary space and attached to the conus medullaris by the tumor capsule.…”

“…There were 13 male and 10 female patients with ages ranging from 5 to 43 years (mean age: 25 years). The tumors predisposed to arise from the lower thoracic and lumbar spinal region 1–23 . Only one case occurred in the middle portion of cervical spinal cord 15 .…”

“…The primary spinal germinomas are extremely rare. In our review of the literature, only 22 cases have been reported previously 1–5 . The incidence of germinomas in the CNS is higher in Japan than other countries.…”

Unusual primary secreting germ cell tumor of the spine

“…9,17,18 A primary location of germ cell tumors in the spine is very rare and so far has been described in 15 other cases, mostly arising in the dorsolumbar tract; in 12 of these cases, the patients were Japanese. [2][3][4][5][6][7][8][9][11][12][13]15,[19][20][21] Of these cases, only five had a ␤-HCG-secreting component like the one that we have described; 15,20,21 our case is only the second one reported in the literature in which the patient is not Asian. 3 The two patients reported on by Hisa, 5 de Monléon, 3 and their colleagues were young children who presented at diagnosis with features typical of precocious puberty and required medical attention before neurological symptoms appeared.…”

Neuroendoscopic findings in patients with intracranial germinomas correlating with diabetes insipidus

“…22,23 The vast majority develop in the midline, specifically the third ventricle and pineal region, and may also spread to or involve any region of the CNS. 1,8,10,13,14,20,[24][25][26]28,31,32,[34][35][36][37]39,40,45,53 For treatment, these tumors are classified into two groups: germinomas and nongerminous germ cell tumors. This latter group consists of embryonal cell carcinomas, endodermal sinus tumors, mature and immature teratomas, choriocarcinomas, and mixed germ cell tumors.…”