Spinal epidural metastasis from pineal germinoma

Tosaka, Masahiko; Ogimi, Tsunao; Itoh, Jun; Itoh, Hideaki; Hayashi, Shigenari; Ono, Nobuo; Nagaya, Takao

doi:10.1007/s00701-003-0022-5

Cited by 9 publications

(2 citation statements)

References 8 publications

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“…Intracranial germ cell tumors have a trend to disseminate throughout the neuroaxis of the ventricles and spinal subarachnoidal space [11,12]. In the present study, intracranial dissemination was detected in 61 (26.3%) patients, and a statistically signi cant difference was found in distribution of primary tumor locations (P<0.001).…”

Section: Discussionsupporting

confidence: 48%

A single-institution study of so-called “non-secreting” intracranial germinomas: neurological characteristics, treatment procedures, and clinical outcomes

Zhou

Lei

Zuo

et al. 2022

Preprint

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Background and PurposeIntracranial germinomas are rare brain tumors. In the present study, we collected data of patients with histology-proven germinomas, and analyzed their neurological characteristics, treatment procedures, and clinical short-term outcomes.MethodsWe reviewed the data of patients with “non-secreting” intracranial germinomas from January 2012 to June 2021 in our institution from Beijing, China.ResultsThere were 162 (69.8%) male patients and 70 (30.2%) female patients. Pineal germinomas were mainly found in male patients (98.3%), and germinomas in sellar/suprasellar region were often observed in female patients (67.5%). The most common clinical presentations were polyuria/polydipsia (42.7%), headache (40.5%), visual disturbance (37.5%), and motor impairment (28.4%). The symptoms of endocrinological alteration had significantly longer duration before hospital admission. Patients with pure germinoma had a higher serum beta-human chorionic gonadotropin (β-HCG) level than the germinoma with syncytiotrophoblastic giant cells (STGCs) (P=0.001), and no significant difference was noted in serum alpha-fetoprotein (AFP) level between the two groups (P=0.540). Tumors with multiple lesions such as bifocal and multifocal diseases had a higher tendency to intracranial dissemination and spinal seeding at diagnosis (P<0.001 and P<0.001, respectively). The mean duration of open craniotomy was 268.8 min with an average volume of blood loss of 316.9 mL, compared with 27.0 min and 6.2 mL in cases who received stereotactic biopsy (P<0.001 and P<0.001). The most common complication in both groups was postoperative hemorrhage (7.0% and 8.5%). Patients who received biopsy had higher KPS scores at hospital discharge than on admission in contrast to open craniotomy (P=0.047). Deterioration of KPS at hospital discharge than on admission was observed in 29 and 1 cases who received craniotomy and biopsy (P<0.001).ConclusionsEndocrinological alteration has longer duration before diagnosis. Patients with multiple lesions such as bifocal and multifocal germinomas have a higher tendency of dissemination, and additional attention should be paid to the imaging findings. Patients may not necessarily benefit from the surgical resection because of the surgical trauma and the postoperative complications, and stereotactic biopsy is highly significant in clinical practice.

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Section: Discussionsupporting

confidence: 48%

A single-institution study of so-called “non-secreting” intracranial germinomas: neurological characteristics, treatment procedures, and clinical outcomes

Zhou

Lei

Zuo

et al. 2022

Preprint

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“…Tosaka et al described a case of a 16-year-old boy, previously treated from a pineal germinoma, who developed rapidly progressing gait disturbances, with paraparesis and anesthesia of the L5-S1 territories on both sides, and urinary retention. Imaging evaluation revealed the presence of spinal epidural metastases, that required surgery in emergency and on pathologic examination were confirmed to be from germinoma (59).…”

Section: Pineal Gland Tumorsmentioning

confidence: 99%

Neuroimaging in emergency: a review of possible role of pineal gland disease

et al. 2019

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The pineal gland can be involved in a variety of neoplastic and congenital masses and tumors. Pineal gland neoplasms occur more frequently in children, accounting for 3-8% of intracranial tumors in the pediatric population. Pineal cysts are small lesions usually asymptomatic and encountered incidentally.Pathologic processes involving the pineal region produce signs and symptoms related to the mass effect on the adjacent structures and invasion of surrounding structures. These include several acute symptoms, such as increased intracranial pressure syndrome from obstruction of the aqueduct and consequent hydrocephalus, and Parinaud syndrome. Pineal apoplexy is rare and refers to the sudden neurological deterioration following hemorrhage in the pineal gland, most commonly into a pineal cyst. Knowledge of the clinical presentation and imaging features of these lesions is essential to narrow the differential diagnosis, especially when presenting with acute onset.

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