Metachronous Germinoma After Total Removal of Mature Teratoma in the Third Ventricle: A Case Report

Abstract

A rare case of intraventricular germinoma in the third ventricle, which occurred 30 months after total removal of mature teratoma on the same location in a 29- yr-old man is presented. Recurrence is supposed to represent an acceleration of localized dysplastic processes of totipotent germ cells present in the midline neuraxis or a growth of unidentified microscopic residue of germinoma component in mature teratoma. Although the radiation therapy after total removal of mature teratoma is still controversial, careful follow-up is warranted for evaluating a possible recurrence of other germ cell tumors.

Mature Intracranial Teratoma

“…On the other hand, there are several single case reports describing a second intracranial germ cell tumor developing usually at a different site and showing a different histological type after total resection of primary intracranial tumor that was in all cases a mature teratoma (16)(17)(18)(19). Moreover, the second tumor was a germinoma.…”

Large Mature Cystic Teratoma of the Third Ventricle in Infancy: A Case Report and Review of Literatures

“…Intracranial teratomas, like teratomas in general, tend to arise from midline structures with the pineal gland being the most common. Their occurrence in the third ventricle has been reported less frequently 9 .…”

Spontaneous intraventricular rupture of a pineal teratoma in a 12-year-old infant

“…12 Because mature teratomas are radioresistant, complete tumor excision is the preferred therapy. 13 The pathophysiology determines the clinical outcome of patients with primary intracranial teratomas. Recurrence after incomplete excision has been observed earlier, because of the possibility of residual immature or malignant tissue.…”