Clinico-biological behavior of germ-cell tumors

Abstract

Fifty-five patients with intracranial germ-cell tumors were treated in Kobe University Hospital between 1972 and 1989. Thirty-four patients were male and 21 were female, and all patients were between 0 and 39 years of age. There was a peak incidence between 16 and 20 years in male patients and 11 and 15 years in female patients. The tumors occurred most frequently in the pineal region (25 cases), followed by the suprasellar (17), both pineal and suprasellar (6), basal ganglia (5), and frontal and temporal lobe (2) regions. There was a male predominance in the incidence of germ-cell tumors except for the patients with suprasellar tumors. Initial symptoms and neurological signs differed according to the location of the tumor. The symptoms of increased intracranial pressure and Parinaud's sign were most frequently seen in patients with a pineal tumor, while diabetes insipidus and visual disturbance were most common in patients with suprasellar tumors. Human chorionic gonadotropin were positive in the serum, cerebrospinal fluid and/or tumor cyst in 14/26 patients, and alpha-fetoprotein in 6/22 patients examined. There were 45 patients with pure germinoma both histologically verified and clinically diagnosed. The 5-year survival rate of the patients with germinoma was 69% in cases in which tumor marker was negative and unknown cases, and 86% in cases where the tumor marker was positive. The authors discuss management of the patients with intracranial germ-cell tumors.

Verbesserte Prognose intracranialer Keimzelltumoren durch intensivierteTherapie: Ergebnisse des Therapieprotokolls MAKEI 89

“…Die Diagnose eines malignen KeimzeIltumors kann klinisch mit Hilfe der bildgebenden Verfahren und der erhöhten Tumormarker (8, 26) gestellt werden, so daß eine präoperative Chemotherapie möglich ist (3,14,35 14,35).…”

Human chorionic gonadotrophin immunoactivity in cystic intracranial tumours

“…Among intracranial lesions, elevated hCG in CSF or serum is found in germ-cell tumours (Jennings et al, 1985). In the differential diagnosis of intracranial tumours, it has been suggested that hCG is a specific tumour marker for the non-germinomatous component of germ-cell tumours (Saitoh et al, 1991), but it has also been described in pure germinomas (Pomarede et al, 1982). Histological verification has been considered unnecessary in the presence of hCG positivity (Allen et al, 1979;Haase & Nsrgaard-Pedersen, 1979).…”

“…In a search for tumour markers in intracranial germ-cell tumours, hCG is usually determined in CSF and serum samples (Hoffman et al, 1991). Elevated hCG levels have also been described in cyst fluid of cystic germinomas (Saitoh et al, 1991); however, cystic germinomas are extremely rare.…”

Intracranial Germ Cell Tumors: A Comprehensive Review of Proposed Embryologic Derivation

“…A review of five large published series on IGCTs during the last 10 years [2,3,5,7,9] shows a total of 276 cases. Analysis of these studies reveals that 49% of the tumors were located in the pineal region, 34% in the suprasellar region, and 5% in both regions which is in agreement with a larger review performed by Jennings et al [11].…”

“…tomas tend to occur in the cerebellar vermis [2,22], Involvement of the cerebral hemispheres is less common; when involved, the basal ganglia and thalami are most commonly the site of origin, with 4-10% of the IGCTs arising from these locations [23][24][25]. Cerebral cortex and cerebral white matter are less commonly affected; in a review of 55 patients, Saitoh et al [5] reported involve ment of the frontal and temporal lobes in only 2 cases. IGCTs have a predilection to metastasize to the ventricu lar system and meninges via the cerebrospinal fluid [8.…”