Isolated CNS metastasis as the first site of recurrence in a child with germ cell tumor of the mediastinum

Berkow, Roger L.; Kelly, David R.

doi:10.1002/mpo.2950240108

Cited by 7 publications

(1 citation statement)

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“…Exceptions included one child with a large mediastinal primary tumor and one with leptomeningeal involvement of a sacrococcygeal tumor. Isolated brain involvement as the first site of tumor recurrence has been reported previously in a child with a mediastinal germ cell tumor, although this patient also had pulmonary involvement at initial presentation 22. Risk factors for the development of brain metastases in adults with germ cell tumors are similar.…”

Section: Discussionmentioning

confidence: 69%

Brain metastases of malignant germ cell tumors in children and adolescents

Spunt¹,

Walsh²,

Krasin³

et al. 2004

Cancer

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BACKGROUNDBrain metastases of pediatric germ cell tumors are uncommon, and there is limited information regarding their incidence, clinical presentation, response to treatment, and influence on survival.METHODSThe authors reviewed the experience with brain metastases from pediatric germ cell tumors at St. Jude Children's Research Hospital (Memphis, TN) over a 40‐year period.RESULTSBetween March 1962 and February 2002, 16 of 206 patients with germ cell tumors (7.8%) had brain metastases at the time of initial presentation (n = 2), later in the course of the illness (n = 12), or at autopsy (n = 2). Twelve of 16 patients (75%) had symptoms referable to the brain (nausea/emesis, headaches, or seizures), and 14 (88%) had pulmonary metastases at the time brain metastases were identified. Patients with brain metastases were more likely to have an extragonadal primary tumor (P = 0.013), advanced‐stage disease at initial presentation (P = 0.016), and choriocarcinoma within the primary tumor (P < 0.001). The incidence of brain metastases was significantly lower in the second 2 decades of the study period (5 of 135 patients [3.7%]) than in the first 2 decades (11 of 71 patients [15.5%]; P = 0.005). Two of the 16 patients in the current study are long‐term survivors.CONCLUSIONSBrain metastases are uncommon in childhood germ cell tumors, and their incidence appears to be decreasing. In the current study, most patients with such metastases were symptomatic and had pulmonary metastases at the time brain metastases were identified. Patients with the highest risk of developing brain metastases include those with extragonadal tumors, those with high disease stage at initial presentation, and those with choriocarcinoma as a component of the primary tumor. The probability of survival is poor, although a small proportion of patients may become long‐term survivors. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 69%