Regression of Tumor in the Pineal Gland after Exclusive Radiotherapy: Case Report

Abstract

Background: Brain tumors are the most common solid neoplasia and the main cause of death from malignancy in children. Germ cell tumors (GCT) of the central nervous system (CNS) are rare. In pediatrics, the main location is close to the pineal gland and germinomas are the most common intracranial GCTs. Objectives and Methods: To describe the case of a patient with a possible germinoma treated exclusively with radiotherapy. The case was studied and came from a referral hospital – João Pesssoa, PB. Results: Reports “impaired failure”, disorientation and headache. Computed tomography: Hydrocephalus and strong tumor suspicion in the pineal region. Alpha-fetoprotein (AFP) and beta-gonadotropin (betaHCG) measurements: Normal. Treatment can be based on radiotherapy or chemotherapy followed by radiotherapy. In this case, radiotherapy was performed at a dosage of 10 Gy, with control, after one month, by means of magnetic resonance imaging that revealed regression of the lesion. The treatment corroborated the hypothesis of a germinoma, which is extremely radiosensitive. However, the regression made it impossible to perform the anatomopathological exam for diagnostic conclusion. Conclusions: It can be seen, then, that primary CNG GCTs are part of a heterogeneous group of extremely rare lesions, with germinoma therapy still controversial. The case shows regression of a possible germinoma only with the use of radiotherapy.