Germinoma of basal ganglia in female: case report and review of the literature

Hao, Shuyu; Liu, Baiyun; Tang, Jie; Jia, Ge; Zhang, Yuqi; Ma, Zhenyu; Wang, Zhongcheng

doi:10.1007/s00381-008-0769-3

Cited by 13 publications

(17 citation statements)

References 15 publications

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“…[3] Therefore, a preoperative diagnosis is critical for developing a treatment plan for these tumors. [4] The radiologic features of germinomas in the pineal gland and supraseller region have been comprehensively interpreted. [5,6] However, the imaging findings of germinomas originated from off-midline regions displayed different patterns from those originating from midline areas.…”

Section: Introductionmentioning

confidence: 99%

Radiologic features of primary intracranial ectopic germinomas

Wei

Shen²,

Tang³

et al. 2016

Medicine

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Rationale:Germinomas are sensitive to radiation therapy and chemotherapy; therefore, correct imaging diagnosis is crucial for them. However, the imaging findings of germinomas originating from off-midline regions displayed different patterns from those originating from midline areas.Patient concerns:The objective of this study is to describe the radiologic features of primary ectopic germinoma. We reviewed the MR and CT findings of 12 patients with histologically proven off-midline ectopic germinomas with off-midline locations.Interventions:All of these patients underwent conventional MR images and 3 of them underwent diffusion images. Additional CT images were available in 3 patients. Analysis was focused on the shape and entity of tumors in images, signs of hemiatrophy, and the involvement of fibers in diffusion images.Outcomes:Well-defined (8/12) and ill-defined margin masses (4/12) were identified according to the shape of the mass. Multicystic masses were seen in 11 of the 12 patients. The solid component of the tumors had a high density (3/3) with calcifications (2/3) on CT images, iso- to hypointensity in T2WI (11/12) and restricted diffusion on apparent diffusion coefficient (ADC) maps (3/3). Hemiatrophy was observed in 5 cases and progressive hemiatrophy was observed in 1 case. Other signs included mild peritumoral edema (10/12), and hydrocephalus (7/12). Additionally, infiltration of the corticospinal tract (CST) was identified on diffusion tensor imaging (DTI) (2/2).Lessons:The results indicate that multicysitic entities and hypointensities in solid components on T2WI and hemiatrophy are the imaging features of ectopic germinomas. DTI has potential for assessing CST involvement.

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Section: Introductionmentioning

confidence: 99%

Radiologic features of primary intracranial ectopic germinomas

Wei

Shen²,

Tang³

et al. 2016

Medicine

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“…However, given the rarity of basal ganglia, thalamic and other non‐midline germinoma, it is unclear if these results can be extrapolated to localized germinomas arising from these locations. As mentioned, these non‐midline lesions have historically been treated with chemotherapy followed by CSI or WBI to achieve similar good outcomes …”

Section: Discussionmentioning

confidence: 59%

“…Germinoma arising from the suprasellar region and pineal gland have been treated with chemotherapy followed by involved‐field or whole ventricular irradiation (WVI) with excellent outcome, with long‐term overall survival of over 95% . For patients with basal ganglia and thalamic germinoma, similar outcomes have been achieved historically with craniospinal irradiation (CSI) or whole brain irradiation (WBI) . However, CSI and WBI are associated with significant long‐term neuropsychological and endocrinological sequelae.…”

Section: Introductionmentioning

confidence: 99%

Clinical and neuropsychological outcome of pediatric non‐midline central nervous system germinoma treated with chemotherapy and reduced dose/volume irradiation: The Children's Hospital Los Angeles experience

Yeo

Kayser

Margol

et al. 2019

Pediatric Blood & Cancer

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Background Germ cell tumors (GCT) arising from non‐midline structures (basal ganglia, thalamus, and posterior fossa) are rare. Although patients with midline (pineal and suprasellar) germinoma have excellent survival with chemotherapy and whole ventricular irradiation (WVI), germinoma in non‐midline locations have traditionally been treated with craniospinal irradiation (CSI) or whole brain irradiation (WBI) to achieve similar outcomes. However, CSI and WBI are associated with significant long‐term neuropsychological sequelae. Methods We describe the clinical and neuropsychological outcomes of patients with non‐midline germinoma treated at the Children's Hospital Los Angeles between 1990 and 2015. Results Nine patients had basal ganglia/thalamic germinoma and one patient had a cerebellar primary. Eight patients received chemotherapy followed by reduced dose/volume irradiation, whereas two patients received chemotherapy alone as upfront therapy. One patient in the chemotherapy alone group relapsed after 4.3 years and was salvaged with CSI plus boost. The overall survival for the entire cohort was 100% at a median follow‐up of 8.5 years. Neuropsychological data were available for six patients at a median of five months (baseline) and 4.2 years (follow‐up) post‐diagnosis. At four‐year follow‐up, data available revealed intact overall cognitive ability, verbal memory, and executive functioning, but persistent deficits in fine motor function. Comparison of baseline to follow‐up suggests a downward trend in working memory, planning/problem‐solving, verbal memory, and visuospatial integration. Conclusion Chemotherapy followed by reduced dose/volume of irradiation is an effective strategy resulting in long‐term survival in patients with non‐midline germinoma. Neuropsychological data suggest relatively minimal morbidity over time.

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“…Approximately 60% of germinomas originate in the pineal region, an area that shows male predominance. Patients with germinomas that grow in this specific location classically present with a headache, hydrocephalus and Parinaud’s syndrome [10]. Approximately 30% of the tumors originate from the suprasellar region, an area that shows a slight female predominance.…”

Section: Discussionmentioning

confidence: 99%

“…The main symptoms of germinomas in this location are polydipsia, polyuria, visual impairment and other hypothalamic-pituitary dysfunctions, which include growth retardation and delayed puberty. Germinomas originating from the basal ganglia and thalamus account for approximately 4 to 10% of intracranial germ cell tumors [10]. With regard to these types of tumor locations, most patients tend to be male and suffer from early symptoms of paralysis, dysnoesia and dyskinesia.…”

Section: Discussionmentioning

confidence: 99%

Primary medulla oblongata germinomas: two case reports and review of the literature

Hao

Feng

et al. 2013

World J Surg Onc

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An intracranial germinoma is a tumor that is sensitive to radiotherapy. As medulla oblongata germinomas are extremely rare, determining an accurate preoperative diagnosis is challenging. Two cases of medulla oblongata lesions were surgically treated, and a postoperative diagnosis of germinoma was determined in both of the cases. The tumor in one patient completely resolved after a treatment course consisting of surgical intervention, radiotherapy and chemotherapy; the other patient, who did not receive any type of adjuvant treatment after surgery, suffered from tumor relapse and died from pneumonia 8 months following surgery. A preoperative diagnosis of medulla oblongata germinoma is difficult because of the lack of specific clinical signs and symptoms. If the correct diagnosis is reached, patients can have a favorable prognosis with proper evaluation and treatment. An invasive operation can potentially lesion and impair the function of the medulla oblongata, which is fatal to the patient.

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Germinoma of basal ganglia in female: case report and review of the literature

Abstract: Histopathologic examination confirmed germinoma. The patient remains stable and tumor-free for 36 months after radiotherapy and chemotherapy. The authors' hypothesis is that it is the individual hormone balance which leads to the male predominance of germinoma in the basal ganglia.

Cited by 13 publications

References 15 publications

Radiologic features of primary intracranial ectopic germinomas

Radiologic features of primary intracranial ectopic germinomas

Clinical and neuropsychological outcome of pediatric non‐midline central nervous system germinoma treated with chemotherapy and reduced dose/volume irradiation: The Children's Hospital Los Angeles experience

Primary medulla oblongata germinomas: two case reports and review of the literature

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