Pineal Germinoma With Granulomatous Reaction-Case Report-

Nishibayashi, Hiroki; Uematsu, Yoshihiko; Terada, Tomoaki; Itakura, Toru

doi:10.2176/nmc.45.415

Cited by 10 publications

(11 citation statements)

References 11 publications

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“…Therefore, preoperative identification of germinoma with granuloma is difficult. Intraoperative findings of a grayish, elastic hard mass may help to recognize this type of germinoma, 12,13) but the lesion was pinkish and soft in our case. Stereotactic biopsy has failed to establish the diagnosis in some cases, so further biopsies or direct surgery may be required.…”

Section: Discussionmentioning

confidence: 66%

“…PLAP is also useful but care should be taken, as negative results may be obtained even in germinoma identified with a two-cell pattern and/or c-kit. 8,13) Expression of the proto-oncogene c-kit is reported in malignant melanoma, breast cancer, small and non-small cell lung cancer, and thyroid tumors. Recent studies have also confirmed that ckit is expressed in germinoma cells and could be a more reliable tumor marker than PLAP.…”

Section: Discussionmentioning

confidence: 99%

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Pineal Germinoma With a Prominent Epithelioid Cell Granuloma Component -Case Report-

Mori

Nakajima

Sakai

et al. 2008

Neurol. Med. Chir.(Tokyo)

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A 20-year-old man presented with a rare case of germinoma with a large component of epithelioid cell granuloma manifesting as oscillopsia. Magnetic resonance imaging demonstrated a mass in the pineal region with homogeneous enhancement with gadolinium. Craniotomy was performed, ending in biopsy. The initial histological diagnosis was epithelioid cell granuloma, but systemic investigation detected no evidence of granulomatous disorder. A revised diagnosis of germinoma was based on positive immunohistochemical staining for placental alkaline phosphatase (PLAP) and c-kit. Histological diagnosis is sometimes incorrect if granulomatous reaction is dominant. Immunohistochemical staining for PLAP and c-kit should be performed if germinoma is clinically suspected.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Pineal Germinoma With a Prominent Epithelioid Cell Granuloma Component -Case Report-

Mori

Nakajima

Sakai

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…In an electronic search of the literature, we found 15 reported cases of intracranial germinoma with a granulomatous reaction and analyzed 16 cases including the present case [6,8,9,10,11,12,13,14]. Patients ranged in age from 8 years to 28 years, with a mean of 17 years.…”

Section: Discussionmentioning

confidence: 99%

“…The 10-year survival rate is 90–95% with total doses of 40–50 Gy in radiotherapy [20]. In the 16 cases with granulomatous germinoma that we examined, biopsy or surgery was performed with radiotherapy in 11 cases, radiotherapy and chemotherapy in 2 cases and chemotherapy in 1 case, and their prognosis was good except in 1 case in which cerebrospinal dissemination occurred [6,8,9,10,11,12,13,14]. …”

Section: Discussionmentioning

confidence: 99%

Neurohypophyseal Granulomatous Germinoma Invading the Right Cavernous Sinus: Case Report and Review of the Literature

Fukushima¹,

Takemura²,

Tsugu³

et al. 2007

Pediatr Neurosurg

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We encountered a rare case of neurohypophyseal germinoma with a prominent granulomatous reaction, which invaded the right cavernous sinus. The neuroimaging and histopathology features in this case were unique, distinguishing it from other types of suprasellar lesions. A 13-year-old boy presented with loss of appetite and polyuria; both symptoms were present for 1 year, and headache, general fatigue and blurred vision present for the prior 2 months. On admission, neurological examination indicated bitemporal hemianopsia and optic atrophy. Endocrinological exam showed panhypopituitarism. Tumor markers such as α-fetoprotein, human growth hormone, carcinoembryonic antigen, and placental alkaline phosphatase were negative. Brain CT revealed a suprasellar tumor with calcification. MR T₁-weighted and T₂-weighted images showed the tumor to be isointense to normal brain parenchyma and to be enhanced densely. The tumor also involved the right cavernous sinus, so that a biopsy was performed by the transsphenoidal approach. On pathologic examination of the specimen, typical large tumor cells with lymphocytic cell infiltration and prominent granulomatous reaction were observed. Neurohypophyseal granulomatous germinoma was diagnosed. Radiotherapy was performed with a total dose of 51 Gy and the tumor shrank remarkably. The patient returned to school under hormone replacement therapy.

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“…1,16) Most specimens of intracranial germinoma contain granulomatous reaction and fibrous tissue, so diagnosis can be difficult. 6,10) Such granulomatous reaction and collagen fiber in germinomas is unlikely to disappear in the short term after radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

Histological Features of Intracranial Germinomas Not Disappearing Immediately After Radiotherapy

Utsuki

Oka

Tanizaki

et al. 2006

Neurol. Med. Chir.(Tokyo)

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The histological features of germinomas were investigated to differentiate tumors which completely disappear immediately after irradiation and those that persist. Eighteen previously untreated patients underwent germinoma biopsy and irradiation or combined irradiation and chemotherapy. Four tumors were located only in the pineal gland, eight in the suprasellar region, two in multiple locations, one in the basal ganglia, and three in other regions. Histologically, the germinomas could be divided into type A found in 13 cases which consisted mainly of large neoplastic cells and small lymphocytes, the so-called two-cell pattern, and type B found in five cases which consisted predominantly of fibrous tissue and granulomatous reaction containing occasional neoplastic cells. Follow-up computed tomography or magnetic resonance imaging showed the enhanced mass lesion disappeared in all cases of type A germinomas within 1 month after treatment, but persisted in all cases of type B germinomas for at least 1 month. Type B tumors required up to 12 months to show complete radiographic resolution. Persistent germinomas consisted predominantly of fibrous tissue and granulomatous reaction containing occasional neoplastic cells.

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Pineal Germinoma With Granulomatous Reaction-Case Report-

Cited by 10 publications

References 11 publications

Pineal Germinoma With a Prominent Epithelioid Cell Granuloma Component -Case Report-

Pineal Germinoma With a Prominent Epithelioid Cell Granuloma Component -Case Report-

Neurohypophyseal Granulomatous Germinoma Invading the Right Cavernous Sinus: Case Report and Review of the Literature

Histological Features of Intracranial Germinomas Not Disappearing Immediately After Radiotherapy

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