Is Regression of Intracranial Germinoma Spontaneous or Diagnostic Radiation-Induced? A Case Report

Abstract

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Perifocal Inflammatory Reaction with Volume Fluctuation Caused by Diagnostic Radiation-Induced Regression in Germinoma Makes Histological Diagnosis Difficult despite Its Disappearance following Treatment: A Significant Pitfall and Countermeasures to It

“…Lymphocytic hypophysitis in children is very rare, and a coincidence with a germinoma has not been described from a histopathological perspective [5] . DRIR-related fluctuation of the tumor volume disguised germinoma as inflammation, although DRIR is a characteristic of germinoma [15,16] .…”

“…Analysis of cerebrospinal fluid (CSF) detected a high level of placental alkaline phosphatase (PLAP) [14] but not of human chorionic gonadotropin β-subunit or α-fetoprotein, which indicated the neurohypophyseal lesion as germinoma and brought the patient from successful radiochemotherapy up to complete remission. The volume fluctuation of the lesion was presumably caused by diagnostic-radiation-induced regression (DRIR) [15,16] . PIR adjacent to germinoma (PIRAG) with DRIR completely disappeared following treatment.…”

“…2 a, c). Because diagnostic radiation can induce the regression of germinoma [15,16] , this DRIR suggested the lesion as germinoma. Thus, fluctuation of the tumor volume is observed not only in inflammation, but also in germinoma.…”