Localization of carcinoembryonic antigen in mature intracranial teratomas

1985 ◽  
Vol 62 (6) ◽  
pp. 870-873 ◽  
Author(s):  
Hirofumi Naganuma ◽  
Hiroshi K. Inoue ◽  
Masaru Nakamura ◽  
Hidehito Koizumi
Keyword(s):  
Carcinoembryonic Antigen ◽  
Germ Cell Tumors ◽  
Immunohistochemical Method ◽  
Surgical Removal ◽  
Content Type ◽  
Normal Limits ◽  
Intracranial Germ Cell Tumors ◽  
Stratified Squamous Epithelium ◽  
Csf Levels ◽  
Glandular Structures

✓ Carcinoembryonic antigen (CEA) in serum and cerebrospinal fluid (CSF) was measured in four patients with intracranial teratoma. The CEA levels were elevated in the CSF of two patients, but were within normal limits in the serum of all four. After surgical removal of the teratomas, which were verified as mature teratomas, CEA was localized by an immunohistochemical method. Positive reactions both to anti-CEA serum and to another anti-CEA serum absorbed with nonspecific cross-reacting antigen were seen in glandular structures, with or without goblet cells, and in some portions of stratified squamous epithelium. It is concluded that CEA, detected in CSF, may originate in mature teratomas, and CEA-positive structures (especially glandular) may differentiate into gastrointestinal tract structures. An examination of serum and CSF levels of CEA may offer additional clues to the diagnosis of intracranial germ-cell tumors.

Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases

1997 ◽  
Vol 86 (3) ◽  
pp. 446-455 ◽  
Author(s):  
Masao Matsutani ◽  
Keiji Sano ◽  
Kintomo Takakura ◽  
Takamitsu Fujimaki ◽  
Osamu Nakamura ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Germ Cell ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Surgical Removal ◽  
Content Type ◽  
Intracranial Germ Cell Tumors ◽  
Mixed Tumors ◽  
Fine Print

✓ The authors analyzed 153 cases of histologically verified intracranial germ cell tumors. The histological diagnosis was germinoma in 63 patients (41.2%), teratoma in 30 (19.6%), and other types of tumors in 60 patients (39.2%). The patients were treated by a consistent policy of surgical removal with histological verification followed by radiation therapy with or without chemotherapy. The 10- and 20-year survival rates of patients with pure germinoma were 92.7% and 80.6%, respectively. The 10-year survival rates of patients with mature teratoma and malignant teratoma were 92.9% and 70.7%, respectively. Patients with pure malignant germ cell tumors (embryonal carcinoma, yolk sac tumor, or choriocarcinoma) had a 3-year survival rate of 27.3%. The mixed tumors were divided into three subgroups: 1) mixed germinoma and teratoma; 2) mixed tumors whose predominant characteristics were germinoma or teratoma combined with some elements of pure malignant tumors; and 3) mixed tumors with predominantly pure malignant elements. The 3-year survival rates were 94.1% for the first group, 70% for the second group, and 9.3% for the third group, and the differences were statistically significant. Twenty-six patients with malignant tumors received chemotherapy that consisted of cisplatin and carboplatin combinations with or without radiation therapy. However, chemotherapy was not significantly more effective than radiation therapy alone. From these treatment results, the authors classified tumors into three groups with different prognoses and proposed a treatment guideline appropriate for the subgroups.

Precocious puberty in a girl with an hCG-secreting suprasellar immature teratoma

1994 ◽  
Vol 81 (4) ◽  
pp. 601-604 ◽  
Author(s):  
Chifumi Kitanaka ◽  
Masao Matsutani ◽  
Shigeo Sora ◽  
Sachiko Kitanaka ◽  
Ayako Tanae ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Precocious Puberty ◽  
Germ Cell Tumors ◽  
Immature Teratoma ◽  
Content Type ◽  
Intracranial Germ Cell Tumors ◽  
Hcg Secretion ◽  
High Level ◽  
Very High ◽  
Fine Print

✓ Although precocious puberty is common in boys with human chorionic gonadotropin (hCG)-secreting brain tumors, it is extremely rare in girls. The authors describe a 6-year-old girl with an hCG-secreting suprasellar immature teratoma who presented with diabetes insipidus, increased intracranial pressure, and precocious puberty. On admission, breast budding was observed. The serum hCG level was 1230 mIU/ml. Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) remained below detectable levels, even after gonadotropin-releasing hormone stimulation. Serum estrogen and androgen were moderately elevated. After chemotherapy, breast budding disappeared with normalization of serum hCG. It has been believed that hCG does not produce precocious puberty in girls in the absence of FSH, and this has been used as an explanation for the rarity of precocious puberty in girls with hCG-secreting brain tumors. However, it has also been reported that hCG has not only LH activity but also intrinsic, although weak, FSH-like activity. In the present case, this FSH-like activity was considered to have played a role in the development of precocious puberty. It is speculated that a very high level of serum hCG can produce precocious puberty in girls. The rarity of intracranial germ-cell tumors with a high potential of hCG secretion may be one of the reasons why hCG-induced precocious puberty is uncommon in girls.

Carcinoembryonic antigen in cerebrospinal fluid of adult brain-tumor patients

1980 ◽  
Vol 53 (5) ◽  
pp. 627-632 ◽  
Author(s):  
Stephen Hill ◽  
Edward Martin ◽  
E. C. Ellison ◽  
William E. Hunt
Keyword(s):  
Cerebrospinal Fluid ◽  
Carcinoembryonic Antigen ◽  
Adult Brain ◽  
Benign Tumors ◽  
Tumor Patients ◽  
Content Type ◽  
The Central Nervous System ◽  
Csf Levels ◽  
Intradural Metastasis ◽  
Cns Malignancies

✓ Carcinoembryonic antigen (CEA) was measured in plasma and cerebrospinal fluid (CSF) in patients with neoplasms and non-neoplastic neurologic conditions of the central nervous system (CNS). Seventy-two control patients had a mean CEAcsf of 0.04 ng/cu cm, 31 patients with benign tumors had a mean CEAcsf of 0.03 ng/cu cm, and 21 patients with malignant CNS tumors had mean CEAcsf of 21.7 ng/cu cm. In the absence of intradural metastasis, the existence of non-CNS malignancies did not cause CEA to appear in the CSF. There was no relationship between the plasma and CSF levels of CEA. The CSF is normally free of CEA, and its detection is strongly suggestive of either primary or secondary intradural malignancy. The titres of CEA decline with effective therapy, and may be of use in monitoring treated patients for recurrence.

Combination chemotherapy with cisplatin and etoposide for malignant intracranial germ-cell tumors

1989 ◽  
Vol 70 (5) ◽  
pp. 676-681 ◽  
Author(s):  
Tatsuya Kobayashi ◽  
Jun Yoshida ◽  
Junzo Ishiyama ◽  
Satoshi Noda ◽  
Akira Kito ◽  
...  
Keyword(s):  
Germ Cell ◽  
Combination Chemotherapy ◽  
Germ Cell Tumors ◽  
Intracranial Germ Cell Tumor ◽  
Content Type ◽  
Total Response Rate ◽  
Intracranial Germ Cell Tumors ◽  
Dna Histograms

✓ Antitumor activity against intracranial malignant teratoma by combination chemotherapy with cisplatin and etoposide was evaluated in experimental and clinical studies. A human teratoma cell line (Tera 2) was exposed in vitro to cisplatin and/or etoposide, after which cell growth inhibition and alterations of deoxyribonucleic acid (DNA) histograms were observed. The results indicated that a synergistic cytotoxic effect was achieved by use of both agents in combination. Four cases of recurrent intracranial germ-cell tumor (three malignant teratomas and one germinoma) were treated with cisplatin and etoposide. With this combinationtherapy, regression of the tumor was observed in all four cases (three complete and one partial), for a total response rate of 100%. During a follow-up period of 9 to 22 months, no recurrence or progression has been noted in three of these cases.

Primary pineal endodermal sinus tumor with elevated serum and CSF alphafetoprotein levels

1980 ◽  
Vol 53 (2) ◽  
pp. 244-248 ◽  
Author(s):  
Norio Arita ◽  
Shoji Bitoh ◽  
Yukitaka Ushio ◽  
Toru Hayakawa ◽  
Hiroshi Hasegawa ◽  
...  
Keyword(s):  
Therapeutic Response ◽  
Elevated Serum ◽  
Germ Cell Tumors ◽  
Pineal Region ◽  
Endodermal Sinus Tumor ◽  
Immunofluorescence Method ◽  
Content Type ◽  
Intracranial Germ Cell Tumors ◽  
Sinus Tumor ◽  
Sensitive Marker

✓ A 12-year-old girl with an alphafetoprotein-producing brain tumor in the pineal region is presented. The marker was detected in both serum and cerebrospinal fluid. The amount of the marker decreased after irradiation of the tumor and systemic chemotherapy and increased prior to tumor recurrence. At autopsy, the tumor was histopathologically diagnosed as an endodermal sinus tumor, and alphafetoprotein was demonstrated in the tumor cells by the immunofluorescence method. Alphafetoprotein may represent a specific and sensitive marker for predicting tumor histopathology and for monitoring the therapeutic response in patients with primary intracranial germ-cell tumors.

Primary embryonal-cell carcinoma of the parietal lobe

1991 ◽  
Vol 75 (3) ◽  
pp. 468-471 ◽  
Author(s):  
Robin F. Koeleveld ◽  
Alan R. Cohen
Keyword(s):  
Cell Carcinoma ◽  
Parietal Lobe ◽  
Germ Cell Tumors ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Content Type ◽  
Imaging Characteristics ◽  
Intracranial Germ Cell Tumors ◽  
Embryonal Cell Carcinoma ◽  
Fine Print

✓ A case of primary embryonal-cell carcinoma of the parietal lobe is reported. The unusually chronic presentation of such a malignant tumor is described. The atypical computerized tomography and magnetic resonance imaging characteristics of this lesion are presented. Review of the literature yielded no previous reports of a lobar embryonal-cell carcinoma. The rarity of intracranial germ-cell tumors presenting off the midline is discussed.

Intracranial germ-cell tumors in children

1991 ◽  
Vol 74 (4) ◽  
pp. 545-551 ◽  
Author(s):  
Harold J. Hoffman ◽  
Hiroshi Otsubo ◽  
E. Bruce Hendrick ◽  
Robin P. Humphreys ◽  
James M. Drake ◽  
...  
Keyword(s):  
Survival Rate ◽  
Adjuvant Therapy ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Pineal Region ◽  
Pineal Tumors ◽  
Content Type ◽  
Suprasellar Region ◽  
Intracranial Germ Cell Tumors ◽  
Sick Children

✓ All patients with confirmed intracranial germ-cell tumors treated at the Hospital of Sick Children during the period January, 1952, to December, 1989, were reviewed. Of the 51 tumors reviewed, 16 were located in the suprasellar region, 32 in the pineal region, and three in both the pineal and the suprasellar regions. Forty-nine patients underwent surgical resection which was total in seven and partial in 20, and consisted of a biopsy in 22. Two patients were managed on the basis of serum and cerebrospinal fluid markers. Surgical tools such as the operating microscope, the ultrasonic surgical aspirator, and the laser beam allowed safe debulking and removal of the deep-seated tumors in the pineal region. There were no operative deaths in the 36 patients treated since 1972, who included 23 with pineal tumors. Twenty-five patients with germinomas received radiotherapy and had a 5-year survival rate of 85.1%. Thirteen patients with non-germinoma germ-cell tumors received radiotherapy and had a 5-year survival rate of 45.5%. On the basis of this review, the authors recommend resection of pineal and suprasellar germ-cell tumors in order to firmly establish an accurate histological diagnosis to guide the extent of adjuvant therapy. In the case of a pure germinoma without evidence of dissemination, adjuvant therapy consists only of local radiotherapy. On the other hand, for malignant non-germinoma germ-cell tumors, adjuvant therapy must include chemotherapy as well as craniospinal axis radiotherapy.

Pathogenesis of intracranial germ cell tumors reconsidered

1999 ◽  
Vol 90 (2) ◽  
pp. 258-264 ◽  
Author(s):  
Keiji Sano
Keyword(s):  
Survival Rate ◽  
Germ Cell ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Yolk Sac ◽  
Endodermal Sinus Tumor ◽  
Content Type ◽  
Intracranial Germ Cell Tumors ◽  
Sinus Tumor ◽  
Fine Print

Object. To determine the pathogenesis of intracranial germ cell tumors (GCTs), the author studied 153 cases of these tumors encountered through 1994, 62.7% of which showed monotypic histological patterns and 37.3% of which were shown to be mixed tumors.Methods. Six patients died soon after admission and underwent autopsy; the other patients underwent surgery followed by radio- and/or chemotherapy. One hundred thirty-four cases were followed through the end of 1997. All patients with a choriocarcinoma died within 1 year. Patients with a yolk sac tumor (endodermal sinus tumor) or an embryonal carcinoma also had poor outcomes. Patients with a mature teratoma had 5- and 10-year survival rates of 93% each. Patients with an immature teratoma had 5- and 10-year survival rates of 86% each, whereas patients who had a teratoma with malignant transformation had a 3-year survival rate of 50%. Patients with a germinoma had a 5-year survival rate of 96% and a 10-year survival rate of 93%. These results may bring into question the validity of the germ cell theory because germinoma, which should be the most undifferentiated tumor according to the theory, was the most benign and choriocarcinoma and yolk sac tumor (endodermal sinus tumor), which should be the most differentiated tumors, were the most malignant according to results obtained during the follow-up study.Conclusions. Germ cell tumors other than germinomas may not originate from one single type of cell (primordial germ cells). The embryonic cells of various stages of embryogenesis may perhaps be misplaced in the bilaminar embryonic disc at the time of the primitive streak formation, becoming involved in the stream of lateral mesoderm and carried to the neural plate area to become incorrectly enfolded into the brain at the time of neural tube formation. The author propounds the following hypothesis: tumors composed of cells resembling the cells that appear in the earlier stages of embryogenesis (ontogenesis) are more malignant than those composed of cells resembling the cells that appear in the later stages of embryogenesis.

Thermoregulatory sweating in palmar hyperhidrosis before and after upper thoracic sympathectomy

1979 ◽  
Vol 50 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Chun-Jen Shih ◽  
Mao-Tsun Lin
Keyword(s):  
Subcutaneous Administration ◽  
Atropine Sulfate ◽  
Normal Group ◽  
Palmar Hyperhidrosis ◽  
Surgical Removal ◽  
Content Type ◽  
Ambient Temperatures ◽  
Thoracic Sympathectomy ◽  
Normal Limits ◽  
Wide Range

✓ To assess thermoregulatory sweating in palmar hyperhidrosis, the authors determined the responses of three groups of normal, hyperhidrotic, and denervated subjects to a variety of ambient temperatures (TA's), 22°, 28°, and 41° C. The normal group had no hyperhidrosis, with intact T2–3 ganglia, the hyperhidrotic group had palm hyperhidrosis with intact T2–3 ganglia, and the denervated group had hyperhydrosis treated with T2–3 ganglionectomy. Both groups of hyperhidrotic and denervated subjects maintained oral and mean skin temperatures within normal limits displayed by the normal group over a wide range of TA's tested. The local sweating rate (LSR) of both the palms and the soles of the feet in the hyperhidrotic group was decreased to a minimal level by either the T2–3 ganglionectomy or the subcutaneous administration of atropine sulfate. Furthermore, the denervated group had a significantly lower LSR of both the forehead and the upper chest regions, but showed a higher LSR of both the ventral thigh and the lateral lumbar regions at a TA of 41° C when compared to the LSR of either the normal or the unoperated hyperhidrotic group. The data demonstrate that the surgical removal of both the T-2 and the T-3 ganglia, although producing no alterations in the thermal balance, does produce abnormalities in quantitative distribution of thermoregulatory sweating in man.

Intracranial germ-cell tumors: natural history and pathogenesis

1985 ◽  
Vol 63 (2) ◽  
pp. 155-167 ◽  
Author(s):  
Mark T. Jennings ◽  
Rebecca Gelman ◽  
Fred Hochberg
Keyword(s):  
Spinal Cord ◽  
Germ Cell ◽  
Third Ventricle ◽  
Age Distribution ◽  
Germ Cell Tumors ◽  
Content Type ◽  
Intracranial Germ Cell Tumors ◽  
Suprasellar Cistern ◽  
Extent Of Disease ◽  
Fine Print

✓ The natural history of primary intracranial germ-cell tumors (GCT's) is defined from 389 previously published cases, of which 65% were germinomas, 18% teratomas, 5% embryonal carcinomas, 7% endodermal sinus tumors, and 5% choriocarcinomas. Intracranial GCT's display specificity in site of origin. Ninety-five percent arise along the midline from the suprasellar cistern (37%) to the pineal gland (48%), and an additional 6% involve both sites. The majority of germinomas (57%) arise in the suprasellar cistern, while most nongerminomatous GCT's (68%) preferentially involve the pineal gland (p < 0.0001). The age distribution of afflicted patients is unimodal, centering with an abrupt surge in frequency in the early pubertal years; 68% of patients are diagnosed between 10 and 21 years of age. Nongerminomatous GCT's demonstrate an earlier age of onset than do germinomas (p < 0.0001). Prolonged symptomatic intervals prior to diagnosis are common in germinomas (p = 0.0007), in suprasellar GCT's (p = 0.001), and among females (p = 0.02). Parasellar germinomas commonly present with diabetes insipidus, visual field defects, and hypothalamic-pituitary failure. Nongerminomatous GCT's present as posterior third ventricular masses with hydrocephalus and midbrain compression. Germ-cell tumors may infiltrate the hypothalamus (11%), or disseminate to involve the third ventricle (22%) and spinal cord (10%). Among a subpopulation of 263 conventionally treated patients, two factors were of prognostic significance: 1) histological diagnosis; germinomas were associated with significantly longer survival than nongerminomatous GCT's (p < 0.0001); and 2) staging of the extent of disease; this emphasizes the ominous character of involvement of the hypothalamus (p = 0.0002), third ventricle (p = 0.02), or spinal cord (p = 0.01). Specific recommendations regarding the necessity of histological diagnosis and staging of the extent of disease are made in light of modern chemotherapeutic advances. The pathogenesis of GCT's may be revealed by their specificity of origin within the positive (suprasellar cistern-suprachiasmatic nucleus) and negative (pineal) regulatory centers for gonadotropin secretion within the diencephalon. The abrupt rise in age distribution at 10 to 12 years suggests that the neuroendocrine events of puberty are an “activating” influence in the malignant expression of these embryonal tumors.

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