GCT-31. DIAGNOSTIC CAPABILITY OF CSF-PLAP ON INTRACRANIAL GERM CELL TUMOR

Abstract BACKGROUND Since the majority of intracranial germ cell tumor(GCT) is sensitive for chemoradiation, biopsy specimens are usually tiny and not enough for accurate pathological diagnosis. To supply complementary diagnostic information, a-fetoprotein or human chorionic gonadotropin-b are important biomarkers. Recently CSF-placental alkaline-phosphatase(PLAP) is also reported as an additional biomarker in intracranial GCT. This study’s purpose is to evaluate the significance of CSF-PLAP. METHODS CSF-PLAP was obtained from the patients with the intraventricular and periventricular tumor before any adjuvant therapy. Definitive diagnoses were made by histopathological information and/or their clinical courses; GCT(germinoma or non-germinomatous GCT(NGGCT)) or other tumors. In GCT, the relationship between CSF-PLAP and tumor reduction volume was evaluated. Tumor volumes were calculated on gadolinium-enhanced T1-weighted magnetic resonance imaging before and after initial chemoradiotherapy. RESULTS Between 2005 and 2019, 42 patients were studied: 24 with GCT and 18 with others. CSF-PLAP value in patients with GCT was significantly higher than those with others: the Specificity was 88% and the sensitivity was 95% at the cutoff value of 8.0 pg/ml. For GCT patients, CSF-PLAP value tended to be higher in germinoma(n=12, mean 4756 pg/ml), compared to the value in NGGCT(n=7, mean 332 pg/ml), although there was no statistical difference. There was a significant positive correlation between initial CSF-PLAP value and tumor reduction volume. CONCLUSION CSF-PLAP is a useful tumor marker for GCT differentiating from the other tumors located in intraventricular and periventricular region and CSF-PLAP value might correlate with the volume of germinomatous component of the tumor.

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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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Intracranial germ cell tumor mimicking granulomatous inflammation

Neurology India ◽

10.4103/0028-3886.117597 ◽

2013 ◽

Vol 61 (4) ◽

pp. 433 ◽

Cited By ~ 2

Author(s):

Sumit Thakar ◽

SunilV Furtado ◽

Nandita Ghosal ◽

AlangarS Hegde

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Granulomatous Inflammation ◽

Cell Tumor ◽

Intracranial Germ Cell Tumor

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HCG-producing Primary Intracranial Germ Cell Tumor with Probable Subsequent Transformation into Rhabdomyosarcoma: A Case Report

Japanese Journal of Neurosurgery ◽

10.7887/jcns.6.550 ◽

1997 ◽

Vol 6 (8) ◽

pp. 550-554

Author(s):

Shinzo Yoshida ◽

Yoshifumi Oda ◽

Yasuto Kawa.kami ◽

Sadahiko Ban ◽

Shinichi Sato ◽

...

Keyword(s):

Case Report ◽

Germ Cell ◽

Germ Cell Tumor ◽

Cell Tumor ◽

Intracranial Germ Cell Tumor ◽

Subsequent Transformation

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Adult Intracranial Germ Cell Tumor

10.32388/10hsg0 ◽

2020 ◽

Author(s):

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Cell Tumor ◽

Intracranial Germ Cell Tumor

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Long term toxicity of intracranial germ cell tumor treatment in adolescents and young adults

Journal of Neuro-Oncology ◽

10.1007/s11060-020-03642-1 ◽

2020 ◽

Vol 149 (3) ◽

pp. 523-532

Author(s):

Jordan Wong ◽

Karen Goddard ◽

Normand Laperriere ◽

Jennifer Dang ◽

Eric Bouffet ◽

...

Keyword(s):

Young Adults ◽

Germ Cell ◽

Germ Cell Tumor ◽

Cell Tumor ◽

Adolescents And Young Adults ◽

Tumor Treatment ◽

Intracranial Germ Cell Tumor

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MPC-08 CLINICOPATHOLOGICAL ANALYSIS OF 12P GAIN IN INTRACRANIAL GERM CELL TUMORS

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.105 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii23-ii23

Author(s):

Kaishi Satomi ◽

Hirokazu Takami ◽

Shintaro Fukushima ◽

Yoichi Nakazato ◽

Shota Tanaka ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Copy Number ◽

Mature Teratoma ◽

Methylation Status ◽

Germ Cell Tumors ◽

Copy Number Variations ◽

Cell Tumor ◽

Testicular Germ Cell ◽

Intracranial Germ Cell Tumor

Abstract BACKGROUND Gain of short arm of chromosome 12 (12p) is commonly observed in testicular germ cell tumors (tGCTs). 12p gain is also frequently seen in intracranial GCTs (iGCTs). However, little is known about the clinical significance of 12p gain in iGCTs. MATERIALS AND METHODS We have collected over 200 fresh frozen tissue samples of iGCTs through the Intracranial Germ Cell Tumor Genome Analysis Consortium in Japan. Firstly, we analyzed DNA methylation status in 83 iGCTs, 3 seminomas and 6 normal control samples using Infinium Human Methylation 450K BeadChip array (Illumina, CA). Idat files were processed using R (Version 3.5.3) and minfi package (1.30.0) to generate copy number variations. Compared with average genome-wide copy number level, 12p gain was determined. Then, 58 iGCTs with clinicopathological information were analyzed for progression-free survival (PFS) and overall survival (OS). Those tumors that consist of only either germinoma and/or mature teratoma components were classified as Favorable Histology (FH) and all the others that contains malignant histological components were classified as Unfavorable Histology (UFH). RESULT 12p gain was observed in 100% (3/3) of seminoma, 13.6% (3/22) of germinoma, 16.7% (1/6) of mature teratoma, 25% (1/4) of immature teratoma, 55% (11/20) of mixed germ cell tumor, 100% (4/4) of yolk sac tumor, 100% (1/1) of embryonal carcinoma, and 100% (1/1) of choriocarcinoma. In total, 44.6% (37/83) of iGCT showed 12p gain. Regarding histological classification, the 12p gain rate in UFH (72%, 18/25) was significantly higher than that in FH (12.1%, 4/33, P<0.01). Both PFS and OS were significantly worse in iGCTs with 12p gain (PFS: P=0.027, OS: P=0.0012). DISCUSSION 12p gain can be a molecular marker to predict prognosis and histological malignancy in iGCTs.

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