Primary Intramedullary Spinal Cord Germinoma  -Case Report-

Kinoshita, Yusuke; Akatsuka, Keiichi; Ohtake, Minoru; Kamitani, Hideki; Watanabe, Takashi

doi:10.2176/nmc.50.592

Cited by 12 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among the previous reports of primary spinal cord germinoma, we summarized cases that required >1 year from the onset of symptoms for an accurate diagnosis (Table 1). [11][12][13][14][15][16][17][18][19] The tumor is commonly located at the thoracic level, and patients usually develop lower-extremity symptoms. Two case reports (Cases 3 and 8) showed no abnormal findings on the initial MRI after onset, but there were abnormal findings on the follow-up MRI.…”

Section: Discussionmentioning

confidence: 99%

Occult Germinoma of the Intramedullary Spinal Cord: A Case Report

HOSHIMARU

TAKAGI

Tsuji

et al. 2023

NMC Case Report Journal

View full text Add to dashboard Cite

Primary germ cell tumors of the central nervous system (CNS) typically occur in the neurohypophysis, hypothalamus, or pineal gland and rarely in the spinal cord. We report a case of a spinal intramedullary tumor, which was first detected on magnetic resonance imaging (MRI) 41 months after the initial symptoms, with a verified pathological diagnosis of germinoma. The initial symptom was an abnormal sensation in the left plantar region that gradually worsened, resulting in severe sensory disturbance, difficulty in standing, and even bladder rectal disturbance. Repeated MRI after the onset failed to provide an imaging diagnosis. The MRI was performed 41 months after the onset and revealed a previously undiagnosed, contrast-enhancing spinal intramedullary neoplastic lesion at the Th11-12 level. Gross total resection of the tumor was successfully performed, and the pathology confirmed the diagnosis of pure germinoma. Postoperative chemotherapy, followed by local radiation, was successfully administered. Among primary germinomas of the CNS, occult germinoma that lacks imaging findings suggestive of tumors in the early stages of onset and becomes apparent over time is often reported as a primary neurohypophyseal germinoma, particularly in adolescents presenting with diabetes insipidus. In the present case, the lesion appeared to correspond to a primary occult germinoma of the intramedullary spinal cord.

show abstract

Section: Discussionmentioning

confidence: 99%

Occult Germinoma of the Intramedullary Spinal Cord: A Case Report

HOSHIMARU

TAKAGI

Tsuji

et al. 2023

NMC Case Report Journal

View full text Add to dashboard Cite

show abstract

“…Intramedullary spinal cord germinoma is rare and has been reported in just 16 primary cases. [4] If CSF is positive for oligoclonal IgG bands, an intramedullary spinal cord germinoma can be initially misdiagnosed as demyelinating disease/MS. Thus, germinomas should be considered among the differential diagnoses for cases of intramedullary spinal cord lesions with oligoclonal IgG bands, particularly when MS-based steroid pulse therapy is ineffective.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary spinal cord germinoma clinically mimicking multiple sclerosis: A case report

Kageyama¹,

Suzuki

Ohara

2019

Surgical Neurology International

View full text Add to dashboard Cite

Background:It is important to differentiate intramedullary neoplastic lesions from nonneoplastic diseases such as multiple sclerosis (MS) and other demyelinating or inflammatory diseases.Case Description:A 26-year-old Japanese male presented with a history of intracranial germinomas and obstructive hydrocephalus, treated with endoscopic surgery, and adjuvant chemotherapy and radiation therapy. Three years later, he developed paresthesias involving the right hand and both lower extremities. The cervical MR scan demonstrated a heterogeneously enhancing intramedullary C1-C2 lesion with surrounding edema. On cytological examination of the cerebrospinal fluid (CSF), there were no neoplastic cells. However, the fluid was positive for oligoclonal immunoglobulin G (IgG) bands. The patient received steroid pulse therapy to address the potential MS diagnosis. The follow-up MR showed reduced edema, but no change in the size of the intramedullary lesion. Therefore, the patient underwent a cervical laminectomy for tumor resection. The pathology was consistent with the same cranial germinoma treated 3 years previously. He subsequently received whole spinal radiation and three courses of chemotherapy.Conclusion:Some spinal cord tumors may produce oligoclonal IgG bands in CSF. In this case, an intramedullary C1-C2 spinal cord germinoma was originally misdiagnosed as MS due to the presence of oligoclonal IgG bands in CSF. Differentiating this tumor from MS and initiating appropriate treatment were critical into the care of this patient.

show abstract

“…Pure germinoma has an especially favorable prognosis and can be cured by radiation therapy alone, with a 5-year survival rate of nearly 100%. 5 …”

Section: Discussionmentioning

confidence: 99%

A rare case of multifocal intramedullary germinoma in cervical spinal cord

2014

View full text Add to dashboard Cite

Study design: Case report. Objectives: We present for the first time a patient with multifocal intramedullary cervical spinal cord germ cell tumors with elevated serum alpha-fetoprotein (AFP). Setting: Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China. Methods: A 19-year-old girl experienced numbness in her right leg 10 months before diagnosis. The numbness gradually became severe and extended up to the thorax. Magnetic resonance imaging (MRI) visualized several intramedullary masses with intensive enhancement and extensive peritumoral edema in the spinal cord at the C3-T1 vertebral body levels. Administration of methylprednisolone caused no treatment effect. The largest mass, which was located at the T1 level inside the normal spinal cord and confirmed by naked eye observation, was completely extracted under a microscope. Postoperative pathological examination demonstrated the so-called 'two-cell pattern,' which is typical of germinoma with placental alkaline phosphatase expression. The serum level of AFP was 64.50 ng ml À1 (normal range: 0-5 ng ml À1 ). The residual tumor was eliminated through radiation therapy (local 30 Gy) following surgery. Afterward, the patient's neurological deficits were improved but not resolved. Results: Six years after surgery, no recurrence was encountered and the patient remained stable. Conclusion: Radiotherapy is the salvage therapy for spinal cord germinoma. Steroids were of no therapeutic value in the treatment of intramedullary spinal cord germinoma.

show abstract

Primary Intramedullary Spinal Cord Germinoma -Case Report-

Cited by 12 publications

References 22 publications

Occult Germinoma of the Intramedullary Spinal Cord: A Case Report

Occult Germinoma of the Intramedullary Spinal Cord: A Case Report

Intramedullary spinal cord germinoma clinically mimicking multiple sclerosis: A case report

A rare case of multifocal intramedullary germinoma in cervical spinal cord

Contact Info

Product

Resources

About