scholarly journals Leptomeningeal Metastases in a Patient with an Extragonadal Germ Cell Tumor

2008 ◽  
Vol 2 ◽  
pp. CMO.S687
Author(s):  
Yoshiaki Kinebuchi ◽  
Masakuni Ishikawa ◽  
Osamu Ishizuka ◽  
Osamu Nishizawa ◽  
Kazuhiro Hongo
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Multidisciplinary Treatment ◽  
Germ Cell Tumors ◽  
Whole Brain Radiotherapy ◽  
Salvage Chemotherapy ◽  
Leptomeningeal Metastases ◽  
Cell Tumor ◽  
Extragonadal Germ Cell Tumor ◽  
Brain Radiotherapy

We present a case of leptomeningeal metastases in a 30-year-old man with an extragonadal germ cell tumor. The patient was referred to our hospital for treatment of an occipital brain metastasis. This lesion was resected, followed by whole brain radiotherapy and further chemotherapy, and a temporary complete remission was achieved. However, leptomeningeal recurrence developed, and despite salvage chemotherapy, the patient died of disease. Although multidisciplinary treatment is given to treat brain metastases of germ cell tumors, the patients’ prognosis has been unsatisfactory. The identification of a standard/effective treatment is required.

Control of extraneural metastasis of a primary intracranial nongerminomatous germ-cell tumor

1989 ◽  
Vol 71 (4) ◽  
pp. 601-604 ◽  
Author(s):  
Jan Watterson ◽  
John R. Priest
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Whole Brain Radiotherapy ◽  
Pineal Region ◽  
Cell Tumor ◽  
High Dose ◽  
Content Type ◽  
Extraneural Metastasis ◽  
Fine Print

✓ Primary intracranial germ-cell tumors are infrequently occurring neoplasms which most often arise in the pineal or sellar regions. Germinomas are seen more frequently than nongerminomatous germ-cell tumors; they are often curable with radiotherapeutic approaches, or with chemotherapy in the rare instance of extraneural metastasis. Nongerminomatous germ-cell tumors are relatively radioresistant and when extraneural metastasis has occurred, they have been fatal in all of the 32 previously reported cases. The case of a 14-year-old girl with a mixed malignant germ-cell tumor arising in the pineal region is reported. Extraneural metastasis to the lung developed 12 months after whole-brain radiotherapy was completed. She was treated with etoposide (VP-16), high-dose cisplatin, vinblastine, and bleomycin and is currently without evidence of disease 46 months postmetastasis.

Cisplatin and Etoposide in Childhood Germ Cell Tumor: Brazilian Pediatric Oncology Society Protocol GCT-91

2009 ◽  
Vol 27 (8) ◽  
pp. 1297-1303 ◽  
Author(s):  
Luiz Fernando Lopes ◽  
Carla Renata Pacheco Macedo ◽  
Elitânia Marinho Pontes ◽  
Simone dos Santos Aguiar ◽  
Maria José Mastellaro ◽  
...  
Keyword(s):  
High Risk ◽  
Germ Cell ◽  
Children And Adolescents ◽  
Germ Cell Tumor ◽  
Multidisciplinary Treatment ◽  
Germ Cell Tumors ◽  
High Risk Group ◽  
Cell Tumor ◽  
Term Survival ◽  
Risk Patients

Purpose In 1988, we formed a consortium of Brazilian institutions to develop uniform standards for the diagnostic assessment and multidisciplinary treatment of children and adolescents with germ cell tumors. We also implemented the first childhood Brazilian germ cell tumor protocol, GCT-91, evaluating two-agent chemotherapy with cisplatin and etoposide (PE). We now report on the clinical characteristics and survival of children and adolescents with germ cell tumors treated on this protocol. Patients and Methods From May 1991 to April 2000, 115 patients (106 assessable patients) were enrolled onto the Brazilian protocol with a diagnosis of germ cell tumor. Results Patients were treated with surgery only (n = 35) and chemotherapy (n = 71). Important prognostic factors included stage (P = .025), surgical procedure at diagnosis according to resectability (P < .032), and abnormal lactate dehydrogenase value at diagnosis (P < .001). Conclusion The improvement in survival by the introduction of a standard protocol is an important achievement. This is of particular importance for smaller institutions with previous limited experience in the treatment of childhood germ cell tumors. In addition, the results of a two-agent regimen with PE were favorable (5-year overall survival rate is 83.3% for patients in the high-risk group [n = 36] who received PE v 58.8% for patients in the high-risk patients group who received PE plus ifosfamide, vinblastine, and bleomycin [n = 17; P = .017]). Thus for selected patients, complex three-agent regimens may not be necessary to achieve long-term survival, even for some patients with advanced disease.

Multiple Tumor-Associated Intracranial Aneurysms Adjacent to a Suprasellar Germ Cell Tumor: Case Report and Review of Literature

2021 ◽  
pp. 1-10
Author(s):  
John K. Yue ◽  
Diana Chang ◽  
Taemin Oh ◽  
Ethan A. Winkler ◽  
Alex Y. Lu ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Intracranial Aneurysms ◽  
Multidisciplinary Treatment ◽  
Clinical History ◽  
Cell Tumor ◽  
Paracrine Signaling ◽  
Current Case ◽  
Case Presentation ◽  
Multiple Tumor

<b><i>Introduction:</i></b> Tumor-associated intracranial aneurysms are rare and not well understood. <b><i>Case Presentation:</i></b> We describe a 4-year-old female with multiple intracranial aneurysms intimately associated with a suprasellar germ cell tumor (GCT). We provide the clinical history, medical, and surgical treatment course, as well as a comprehensive and concise synthesis of the literature on tumor-associated aneurysms. <b><i>Discussion:</i></b> We discuss mechanisms for aneurysm formation with relevance to the current case, including cellular and paracrine signaling pertinent to suprasellar GCTs and possible molecular pathways involved. We review the complex multidisciplinary treatment required for complex tumor and cerebrovascular interactions.

scholarly journals 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

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.

scholarly journals Cryptorchidism and Extragonadal Germ Cell Tumor

1995 ◽  
Vol 55 (1) ◽  
pp. 44-45 ◽  
Author(s):  
L.Y. Dirix ◽  
E. Wouters ◽  
J. van Nueten ◽  
W. van Eerdeweg ◽  
A.T. van Oosterom
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Cell Tumor ◽  
Extragonadal Germ Cell Tumor

scholarly journals Recovery from Choriocarcinoma Syndrome Associated with a Metastatic Extragonadal Germ Cell Tumor Hemorrhage

2016 ◽  
Vol 10 (1) ◽  
pp. 198-203 ◽  
Author(s):  
Koji Komori ◽  
Daisuke  Takahari ◽  
Kenya Kimura ◽  
Takashi Kinoshita ◽  
Seiji Ito ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Emergency Operation ◽  
Abdominal Distension ◽  
Massive Hemorrhage ◽  
Cell Tumor ◽  
Inferior Mesenteric Vein ◽  
Extragonadal Germ Cell Tumor ◽  
Life Threatening ◽  
Substantial Risk

A germ cell tumor is the most common form of malignancy in early male life, and can be classified as either seminomatous or nonseminomatous. Choriocarcinoma, comprised of nonseminomatous germ cells, is the most aggressive type of germ cell tumor and characteristically metastasizes to the retroperitoneal lymph nodes and less frequently to the lungs, liver, bone or brain [Shibuya et al., 2009;48: 551–554]. A 56-year-old man was admitted to another hospital complaining of abdominal distension. Symptoms included anorexia, vomiting, and diarrhea. The patient was diagnosed with an extragonadal germ cell tumor and referred to our hospital to receive chemotherapy. The day after admission, the patient’s abdominal distension gradually worsened. An emergency operation revealed venous hemorrhage from the surface of a metastatic extragonadal germ cell tumor between the ligament of Treitz and the inferior mesenteric vein in a horizontal position. Hemostatic treatment was performed with 4-0 proline thread attached to a medicated cotton sponge, rather than using a simple proline thread, and the closure area was manually compressed. Chemotherapy was initiated on postoperative day 10. A metastatic extragonadal germ cell tumor that causes massive hemorrhage and gastrointestinal hemorrhage is very rare, and represents a life-threatening emergency. If the patient’s condition carries a substantial risk of bleeding to death, it may be worthwhile to attempt abdominal operations.

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