Primary chemotherapy for intracranial germ cell tumors: Results of the third international CNS germ cell tumor study

Abstract We found combination chemotherapy with cisplatinum, vinblastine, and bleomycin (PVB therapy) effective in the treatment of a patient with a pineal germ cell tumor with peritoneal dissemination. The metastatic complication may have been attributable to the ventriculoperitoneal shunt tube. After the first course of PVB therapy, the disseminated tumors were decreased in size; no residual tumors were detected after the third course by laparoscopic examination, computed tomographic scanning, or echogram. Our results suggest that combined PVB therapy is effective in the treatment of extraneural metastasis from intracranial germ cell tumors. (18:802-804, 1986)

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Surgical management of primary central nervous system germ cell tumors

Journal of Neurosurgery Pediatrics ◽

10.3171/2010.5.peds09112 ◽

2010 ◽

Vol 6 (2) ◽

pp. 125-130 ◽

Cited By ~ 42

Author(s):

Mark M. Souweidane ◽

Mark D. Krieger ◽

Howard L. Weiner ◽

Jonathan L. Finlay

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Germ Cell ◽

International Symposium ◽

Surgical Management ◽

Germ Cell Tumor ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Therapeutic Approaches ◽

Cns Germ Cell Tumor

The successful treatment of children with a primary CNS germ cell tumor can be greatly influenced by the neurosurgeon involved in the diagnostic and therapeutic care of these children. Variability in surgical philosophies no doubt exists due to the relatively infrequent incidence of these tumors, a lack of consensus regarding diagnostic and therapeutic approaches, and the advent of recent surgical innovations. Many of these issues were discussed at the Second International Symposium on Central Nervous System Germ Cell Tumors through presented abstracts and invited presentations. The neurosurgical aspects of these proceedings are summarized here in an effort to present the agreed-upon and debated issues that may confront the pediatric neurosurgeon.

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A Rare Case of Intracranial Nongerminomatous Germ Cell Tumor in a 21-Year-Old Romanian Male

Case Reports in Oncological Medicine ◽

10.1155/2020/3787250 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Minesh Nandi ◽

Rahul Anil ◽

Edward Hamaty ◽

William Adams ◽

David Stidd ◽

...

Keyword(s):

Germ Cell ◽

Tumor Markers ◽

Germ Cell Tumor ◽

Rare Case ◽

Obstructive Hydrocephalus ◽

Elevated Serum ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Third Ventriculostomy ◽

Intracranial Germ Cell Tumors

Extragonadal germ cell tumors are a rare entity that is more prevalent in infants and young children, with preference to midline structures. The category of intracranial germ cell tumors is divided into pure germ cell tumors (GCTs) versus nongerminomatous germ cell tumors (NGGCTs). They are usually present in the second decade of life with a male preponderance. We present here a rare case of intracranial NGGCT in a 21-year-old Romanian male, who presented with complaints of emesis, ataxic gait, and diplopia. A computed tomography scan of the head in the emergency department revealed a pineal/suprapineal mass along with obstructive hydrocephalus and dilated lateral and third ventricles without any bleeding. MRI of the cervical, thoracic, and lumbar spine showed no evidence of leptomeningeal metastasis. The patient had elevated serum markers of beta-hCG and AFP, which pointed towards a diagnosis of nongerm cell tumor, as in pure GCTs, these markers are normal. To relieve the obstruction from the mass effect, the patient had an endoscopic third ventriculostomy (EVT). However, after the procedure, he developed central diabetes insipidus as a complication with a triphasic response. Biopsy of the mass revealed atypical cells with granular architecture and atypical glands with positive immune histological markers for NGGCT. These findings supported the diagnosis of mixed germ cell tumor with yolk sac carcinoma and seminoma components. Patient’s transient central diabetes resolved with normalization in his urine output. He was eventually stabilized and returned to Romania for further management. In summary, intracranial germ cell tumors are rare brain tumors that should be distinguished based on histology and tumor markers as they will help in the guidance of therapy. An initial evaluation with neuroimaging, tumor markers, cytology from CSF, and biopsy is a must to distinguish further treatment and prognosis.

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Response to high-dose cisplatin and etoposide in advanced germ cell tumors in children: Results of the Brazilian germ cell tumor study

Medical and Pediatric Oncology ◽

10.1002/mpo.2950250506 ◽

1995 ◽

Vol 25 (5) ◽

pp. 396-399 ◽

Cited By ~ 9

Author(s):

Luiz Fernando Lopes ◽

Beatriz De Camargo ◽

Miriam Dondonis ◽

Rogerio Agenor de Araujo ◽

Elizabeth Morinaka ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Germ Cell Tumors ◽

Cell Tumor ◽

High Dose ◽

Tumor Study

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GCT-06. DIAGNOSIS OF A RARE CASE OF RECURRENT GERM CELL TUMOR BY CSF PLACENTAL ALKALINE PHOSPHATASE PRESENTING WITH DIFFUSE INTRAAXIAL ABNORMALITY IN THE LOWER BRAINSTEM

Neuro-Oncology ◽

10.1093/neuonc/noaa222.228 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii329-iii329

Author(s):

Hiroki Yamada ◽

Tomohiro Abiko ◽

Hirokazu Fujiwara ◽

Kazunari Yoshida ◽

Hikaru Sasaki

Keyword(s):

Alkaline Phosphatase ◽

Germ Cell ◽

Germ Cell Tumor ◽

Rare Case ◽

Cervical Spinal Cord ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Placental Alkaline Phosphatase ◽

Steroid Pulse ◽

Platinum Based Chemotherapy

Abstract INTRODUCTION Germ cell tumors in the central nervous system (CNS) typically arise either at suprasellar and/or pineal region, and occasionally at basal ganglia. We report a case of diagnostically challenging, recurrent germ cell tumor presented with diffuse intraaxial abnormality in and across the lower brainstem, which was diagnosed by the elevated placental alkaline phosphatase (PLAP) level in cerebrospinal fluid (CSF). CASE DESCRIPTION: A 28-year-old man had been treated by chemoradiotherapy at the previous hospital for bifocal suprasellar and pineal lesions with the provisional diagnosis of germinoma without histological confirmation. Three years later, he presented with progressive weakness of bilateral extremities for weeks. Magnetic resonance imaging showed a diffuse, bilaterally symmetric high intensity lesion on T2-weighted image with slight contrast enhancement across the ventral side of the medulla oblongata to the upper cervical spinal cord. Serum and CSF hCG, hCG-β, and AFP were all negative. Since the image findings were atypical for recurrent germ cell tumor, some kind of myelitis was initially suspected. Therefore, steroid pulse therapy was administered. However, the patient’s symptom was still gradually progressing. Then, the CSF PLAP turned out to be positive, indicating the recurrence of germinoma. Accordingly, platinum-based chemotherapy was administered, and the imaging findings, patient’s symptoms, and CSF PLAP began to improve. The patient is to be treated with radiotherapy following chemotherapy. CONCLUSION We report a rare case of CNS germ cell tumor that presented with diffuse intraaxial lesion in the lower brainstem in which examination of CSF PLAP was extremely useful.

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A rare case of mixed germ cell tumor in a teenage girl: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172378 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2663

Author(s):

Faraz S. Vali ◽

Amit Kyal ◽

Parul I. Chaudhary ◽

Sujatha Das ◽

Aprateem Mukherjee ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Embryonal Carcinoma ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Ca 125 ◽

Gestational Choriocarcinoma ◽

Mixed Germ Cell Tumor ◽

Initial Surgery ◽

Alpha Feto Protein

Germ cell tumors represent only 20% to 25% of all benign and malignant ovarian neoplasms. Mixed germ cell tumors are a rare variety of non–dysgerminomatous germ cell tumors. They contain two or more elements; the most frequent combination being a dysgerminoma and an EST (Endodermal Sinus Tumor). We present a case of malignant mixed germ cell tumor comprising of yolk sac tumor, embryonal carcinoma and choriocarcinoma. A 13-year-old girl presented with a huge 25 x 18 cm mass in abdomen with raised values of CA-125, hCG, AFP (alpha-feto protein) and LDH (lactate dehydrogenase). She underwent laparotomy followed by unilateral salpingoopherectomy and infracolic omentectomy. Histopathology report revealed malignant mixed germ cell tumor comprising predominantly of EST with elements of embryonal carcinoma and non-gestational choriocarcinoma. Following surgery, she was started on adjuvant chemotherapy (Bleomycin, Etoposide and Cisplatin regimen). Mixed germ cell tumor (YST/EST, non-gestational choriocarcinoma and embryonal carcinoma) is a very rare tumor. Careful initial surgery with adequate staging biopsies followed by combination chemotherapy can greatly improve the prognosis of these patients

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Pediatric Germ Cell Tumors: An Experience of 7 Years in a Tertiary Hospital of Bangladesh

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49692 ◽

2020 ◽

Vol 35 (2) ◽

pp. 119-122

Author(s):

SM Rashed Zahangir Kabir ◽

Md Waheed Akhtar ◽

Farida Yasmin

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Tertiary Care ◽

Germ Cell Tumors ◽

Yolk Sac ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Treatment Modalities ◽

Care Hospital ◽

Childhood Malignancies

Introduction: Germ cell tumors are a group of tumors with different clinical presentation and histological and biological characteristics. Malignant germ cell tumors occur at all ages with a trend of bimodal distribution in infancy and adolescence. Objective: To evaluate the demographic characteristics, distribution of different types of germ cell tumor, treatment modalities and outcome of germ cell tumor in children in a tertiary care hospital of Bangladesh. Methods: In this retrospective study, data regarding age and sex distribution, location, types of tumors, management of germ cell tumor in children were retrieved from the medical records of pediatric oncology department in NICRH, Dhaka from 2008 to 2014. Results: Out of total 87 patients female were 50 and male 37. Most of the patients were up to 5 years of age. The gonadal germ cell tumors (80%) were more than extragonadal tumor (20%) in both male and female patients. The most common germ cell tumor was dysgerminoma (32%) followed by yolk sac tumor (29.8%) and teratoma (19.5%). Yolk Sac Tumor (51.4%) was the most common in male and dysgerminoma (56%) the commonest in female. Out of 87, seventy two (82.7%) received chemotherapy following surgery. Among those 72 patients who received chemotherapy 49 (68 %) patients completed their treatment. Until the last follow up 71.4% patients remained alive and tumor free. Conclusion: Germ cell tumors are the most variable tumor of all childhood malignancies that has difference in age, sex, location and histological subtypes. Gonadal tumors have better prognosis than extragonadal tumors in both the sex. DS (Child) H J 2019; 35(2) : 119-122

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