Diagnostic sensitivity of serum and lumbar CSF bHCG in newly diagnosed CNS germinoma

Allen, Jeffrey C.; Chacko, J; Donahue, Bernadine R.; Dhall, Girish; Kretschmar, Cynthia S.; Jakacki, Regina I.; Holmes, Emi; Pollack, Ian F.

doi:10.1002/pbc.24097

Cited by 68 publications

(41 citation statements)

References 14 publications

(15 reference statements)

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“…59 Lumbar CSF is more sensitive than ventricular fluid. Pure germinomas are usually nonsecreting, but may have elevated levels of "-human chorionic gonadotropin ("-HCG).…”

Section: Pineal Region Tumorsmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Brain Tumors

Wells¹,

Packer²

2015

CONTINUUM: Lifelong Learning in Neurology

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The presentation of a pediatric brain tumor is dependent on the type of tumor, its location in the nervous system, and the age of the child. Diagnostic workup varies depending on the location of the tumor and the tumor's propensity to disseminate in the nervous system. Survival has improved for pediatric brain tumors, particularly medulloblastoma, as a result of improved surgical techniques and rational use of postoperative radiation and chemotherapy. For medulloblastoma, recent studies have sought to maintain or improve survival while decreasing neurologic sequelae, particularly from radiation in young children. For other childhood brain tumor types, improvements in outcome are not as clear-cut. New molecular insights will likely alter classification, risk stratification, and therapy in the near future.

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“…59 Lumbar CSF is more sensitive than ventricular fluid. Pure germinomas are usually nonsecreting, but may have elevated levels of "-human chorionic gonadotropin ("-HCG).…”

Section: Pineal Region Tumorsmentioning

confidence: 99%

“…Biopsy is considered mandatory in those tumors without marker elevation. 2,59,60 Management of pineal region tumors includes biopsy or attempts at surgical resection, alleviation of hydrocephalus,…”

Section: Pineal Region Tumorsmentioning

confidence: 99%

Pediatric Brain Tumors

Wells¹,

Packer²

2015

CONTINUUM: Lifelong Learning in Neurology

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show abstract

“…Pure germinomas should always have normal AFP levels in the serum and lumbar CSF but may have a low level of HCG. Assays of lumbar CSF is imperative for an accurate diagnosis and staging since oncoprotein levels are often much higher than in the serum [12]. Lumbar CSF assays are a more reliable source than ventricular CSF for repeated accessibility and published norms [13].…”

Section: Clinical Presentation Diagnosis and Staging Of Cns Germinomamentioning

confidence: 99%

Management of CNS germinoma

Osorio

Allen

2015

CNS Oncol.

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The following is a general overview of the management of CNS germinomas. Over the last 35 years, CNS germinomas have become one of the pediatric brain tumors with the best outcomes with a greater than 85% overall survival over 5 years. This is in part due to the fact that germinomas are very responsive to chemotherapy and radiation. Some of the major challenges going forward will be to find ways to minimize the adverse effects of our treatments particularly with regard to radiation and to improve the quality of life of patients who develop neurologic, neurocognitive and/or endocrine deficiencies.

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“…39 Elevated serum and CSF AFP and BHCG may serve as markers for germ cell tumours, although they do lack sensitivity. 40 Germinomas may present with normal AFP levels in both serum and CSF, and normal or mildly elevated BHCG levels. 41 The classic MRI finding in CDI is loss of the posterior pituitary two-thirds of cases.…”

Section: Further Inve S Ti G Ati On Smentioning

confidence: 99%

Diagnosis and management of central diabetes insipidus in adults

Garrahy

Moran

Thompson

2018

Clinical Endocrinology

103

111

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Central diabetes insipidus (CDI) is characterized by hypotonic polyuria due to impairment of AVP secretion from the posterior pituitary. In clinical practice, it needs to be distinguished from renal resistance to the antidiuretic effects of AVP (nephrogenic DI), and abnormalities of thirst appreciation (primary polydipsia). As nephrogenic diabetes insipidus is rare in adults, unless they are treated with lithium salts, the practical challenge is how to differentiate between CDI and clinical disorders of excess thirst. The differential diagnosis is usually straight forward, but the recommended gold standard test, the water deprivation test, is not without interpretative pitfalls. The addition of the measurement of plasma AVP concentrations improves diagnostic accuracy, but the radioimmunoassay for AVP is technically difficult, and is only available in a few specialized centres. More recently, the measurement of plasma copeptin concentrations has been claimed to provide a reliable alternative to measurement of plasma AVP, without the sampling handling challenges. In addition, the measurement of thirst ratings can help the differentiation between CDI and primary polydipsia. Once the diagnosis of CDI is biochemically certain, investigations to determine the cause of AVP deficiency are needed. In this review, we will outline the diagnostic approach to polyuria, revisit the caveats of the water deprivation test and review recent data on value of adding AVP/copeptin measurement. We will also discuss treatment strategies for CDI, with analysis of potential complications of treatment.

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Diagnostic sensitivity of serum and lumbar CSF bHCG in newly diagnosed CNS germinoma

Cited by 68 publications

References 14 publications

Pediatric Brain Tumors

Pediatric Brain Tumors

Management of CNS germinoma

Diagnosis and management of central diabetes insipidus in adults

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