Germ cell tumors of the central nervous system originating from non-pineal regions: CT and MR features

Radiological Features of Germinoma Arising From Atypical Locations-Three Case Reports-

“…5,7,13) In addition, most of these cases are multiple cysts. 5,7,18,20) Therefore, most germinomas have cysts, except for those in the pineal gland, which agrees with the present neuroimaging features of germinoma. Hemorrhage may contribute to the cyst formation, since the cyst fluid is most often xanthochromic.…”

“…These specific findings are not common in germinoma in the usual locations. 20) The Ki-67 staining index was 48-67% in these three cases, and is 40-75% in germinoma in the usual locations. 9) Germinomas in atypical locations do not tend to become large because of the high proliferation potential.…”

“…Germinoma in the pineal region or suprasellar area is often identified before becoming too large or developing a cyst because symptoms such as increased intracranial pressure due to hydrocephalus, eye movement disorders, visual disturbance, visual field disorders, and diabetes insipidus develop even if the tumor and cyst are small. 20) On the other hand, germinoma in the basal ganglia can often be quite large with a cyst before discovery due to the absence of symptoms. 5,7,13) Similarly, germinoma in the frontal lobe, the temporal lobe of the subordinate hemisphere, or the corpus callosum is usually large and contains a large cyst because of the minimal or nonspecific clinical findings.…”

“…6,8,15,19) Cysts are found in about 40% of germinomas. 2,11,20) However, cysts occur in 50-100% of germinomas in the suprasellar area 18,20) and 83-90% in the basal ganglia. 5,7,13) In addition, most of these cases are multiple cysts.…”

“…2,12,18,20) Such tumors located in other regions are most often multiple lesions also occurring in the pineal region, suprasellar area, or basal ganglia. 12,18) Only 3.2% of solitary tumors occur at other sites.…”