Intracranial germ cell tumors: a multi-institutional experience from three tertiary care centers in India

Kakkar, Aanchal; Biswas, Ahitgani; Kalyani, N.; Chatterjee, Uttara; Suri, Vaishali; Sharma, Mehar Chand; Goyal, Neeraj Kumar; Sharma, Bhawani Shankar; Mallick, Supriya; Julka, Pramod Kumar; Chinnaswamy, Girish; Arora, Brijesh; Epari, Sridhar; Chatterjee, Sandip; Jalali, Rakesh; Sarkar, Chitra

doi:10.1007/s00381-016-3167-2

Cited by 27 publications

(21 citation statements)

References 43 publications

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“…These data were similar to the ratio in a Japanese study. The sex ratio in this study was higher than that in a US study and an Indian study (1.54e2.4), 14,15 but slightly lower than that in a Korean study and a previous Taiwanese study (3.42 and 4, respectively). 8,16 Some differences may have occurred owing to ethnic differences.…”

Section: Discussioncontrasting

confidence: 82%

Neurological and endocrinological manifestations of 49 children with intracranial pure germinoma at initial diagnosis in Taiwan

Chang

Chiu

Jung

et al. 2021

Pediatrics & Neonatology

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Background: Intracranial pure germinoma is a rare extragonadal neoplasm. Affected patients may have motor impairment, visual disturbance, neurological signs, and endocrine disorder, depending on the size and location of the tumor. This study investigated and analyzed patients' demographic data and neuroimaging, clinical, laboratory, and endocrinological findings. Methods: We performed a retrospective chart review of 49 children diagnosed with pure germinoma in Taiwan from 1990 to 2018. The initial clinical presentation, tumor markers (beta-hCG, alpha fetoprotein, and carcinoembryonic antigen), pituitary function, and brain images were reviewed and analyzed. Results: This study included 49 patients (37 boys and 12 girls). Their ages ranged from 7.5 to 17.9 years, and the mean age at diagnosis was 13.6 years. Initial symptoms included visual disturbance (n Z 23, 47.9%), motor impairment (n Z 20, 40.8%), polyuria (n Z 20, 40.8%), headache (n Z 17, 34.7%), dizziness or vertigo (n Z 14, 28.6%), nausea/vomiting (n Z 13, 26.5%), and short stature (n Z 8, 18.2%). Laboratory data indicated growth hormone deficiency or low IGF-1 levels (n Z 18, 85.7%), adrenal insufficiency (n Z 21, 77.8%), central diabetes insipidus (n Z 27, 55.1%), central hypothyroidism (n Z 15, 48.4%), and hypogonadotropic

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Section: Discussioncontrasting

confidence: 82%

Neurological and endocrinological manifestations of 49 children with intracranial pure germinoma at initial diagnosis in Taiwan

Chang

Chiu

Jung

et al. 2021

Pediatrics & Neonatology

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“…Intracranial GCTs are the most common brain tumours in the paediatric and adolescent population, with incidence rates differing among the various ethnic groups 11 . There is a higher incidence in Asia and Pacific Islanders, comprising 8%‐15% of all childhood brain tumours from a series in Taiwan, Japan and Korea vs 0.1%‐3% in the North America and Europe 30‐34 . The reasons for these differences may be related not only to the genetic predisposition in the Asian population, but also to different patient definitions and tumour classifications 32,33 .…”

Section: Suprasellar Germinomamentioning

confidence: 99%

A clinical approach to parasellar lesions in the transition age

Sbardella

Puliani

Feola

et al. 2021

J Neuroendocrinology

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Many reviews have summarised the pathology and management of the parasellar region in adult patients, although an analysis of these aspects in the transition years, from puberty onset to the age of peak bone mass, has been lacking. A comprehensive search of English‐language original articles, published from 2000 to 2020, was conducted in the MEDLINE database (December 2019 to March 2020). We selected all studies regarding epidemiology, diagnosis and management of the following parasellar lesions: germinoma, craniopharyngioma, Langerhans cell histiocytosis, optic glioma, hypothalamic hamartoma, tuber cinereum hamartoma, cranial chordoma, Rathke cleft cyst, hypophysitis and hypothalamitis during the transition age from childhood to adulthood. In the present review, we provide an overview of the principal parasellar lesions occurring in the transition age. Symptoms are usually a result of the mass effect of the lesions on nearby structures, as well as anterior pituitary deficits. Diabetes insipidus occurs frequently in these patients. In this age group, pubertal developmental disorders may be more evident compared to other stages of life. Parasellar lesions in the transition age mostly include neoplastic lesions such as germinomas, hamartomas, optic gliomas, craniopharyngiomas Langerhans cell histiocytosis and chordomas, and rarely inflammatory lesions (hypophysitis, hypothalamitis). There are limited data on the management of parasellar lesions in the transition age. Endocrine evaluation is crucial for identifying conditions that require hormonal treatment so that they can be treated early to improve the quality of life of the individual patient in this complex age range. The clinical approach to parasellar lesions involves a multidisciplinary effort.

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“…[ 7 8 ] Recently, a multi-institutional study, comprising the data from three institutions in India, reported that the GCT accounted for 0.43% of CNS tumors. [ 9 ] Further, a review of management strategies of these tumors over a long time and their evolution will aid in better management of these tumors. The present study, the largest single institutional study from India, to the best of our knowledge, attempts to document the proportion of GCTs managed in a tertiary neurosurgical institute over a period of 16 years, identify the pathological spectrum, and correlate clinically and elaborate on the management strategies of these patients.…”

Section: Introductionmentioning

confidence: 99%

Intracranial Germ Cell Tumors: Spectrum of Disease in an Indian Cohort and Management Strategies

Borde

Arivazhagan

Srinivas

et al. 2018

Journal of Neurosciences in Rural Practice

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Background:Germ cell tumors (GCTs) represent approximately 3% of primary pediatric brain tumors in the West, whereas in Asia, they constitute between 8% and 15% of pediatric brain tumors.Methods:We retrospectively studied all patients with intracranial GCT managed at our institute from January 1998 to December 2013. The clinical data and radiological data were analyzed.Results:Forty-eight patients with intracranial GCT including 36 males and 16 females formed the cohort. The proportion of GCT in our study was 0.29%. The mean age was 16.5 ± 2.5 years. Germinomas constituted 56.3% and nongerminomatous GCTs constituted 43.7% of all the tumors. The most common location was posterior third ventricle (58.3%) followed by suprasellar (22.9%). Histopathological diagnosis was obtained in almost all patients (96%). Surgical procedures included tumor decompression (71.7%), stereotactic biopsy (13%), and endoscopic third ventriculostomy and biopsy (15%). Patient's age, location of the tumor, and histology did not influence the survival. Women with GCTs had poorer survival when compared to men.Conclusions:The present study documented a lower hospital-based incidence of GCT in Indian cohort. A multidisciplinary approach including surgical strategy based on location, appropriate radiation planning, and chemotherapy is needed for effective treatment and improved outcomes.

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Intracranial germ cell tumors: a multi-institutional experience from three tertiary care centers in India

Cited by 27 publications

References 43 publications

Neurological and endocrinological manifestations of 49 children with intracranial pure germinoma at initial diagnosis in Taiwan

Neurological and endocrinological manifestations of 49 children with intracranial pure germinoma at initial diagnosis in Taiwan

A clinical approach to parasellar lesions in the transition age

Intracranial Germ Cell Tumors: Spectrum of Disease in an Indian Cohort and Management Strategies

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