[Mixed tumors of the pineal area. Diagnosis and therapy consisting of secreting germ cell tumor].
Primary intracranial germ cell tumors are rare neurological diseases. Secreting germ cell tumors that predominantly appear in the pineal region are characterized by elevated levels of beta-HCG and AFP in CSF. Adequate diagnostic and therapeutic regimens of these tumors are still under debate. We present the case of a patient suffering from spinal metastasis of a secreting germ cell tumor with raised levels of beta-HCG in CSF. Six years before, a pineocytoma of intermediate differentiation had been diagnosed by stereotaxic biopsy. This demonstrates the importance of an early detection of a germ cell neoplasm in case of midline-sized brain-tumors by evaluation of beta-HCG and AFP in CSF and serum. Today, different therapeutic strategies depending on the histological diagnosis are available and justify a high priority of a surgical tumor biopsy. However, the value of stereotaxic procedures remains controversial. Recently published data gave evidence of a definite improved prognosis of secreting CNS germ cell tumors following combined treatment with high-dose polychemotherapy, surgical resection and radiation of the tumor area. beta-HCG and AFP may serve as useful markers to enable follow-up of the disease.
Klinik und Poliklinik für Neurologie, Universität zu Köln.
R
R
Hilker
R
R
Mielke
F
F
Berthold
R
R
Schröder
W D
WD
Heiss
D000328:Adult; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid*; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000134:cerebrospinal fluid*; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D010870:Pineal Gland / Q000473:pathology; D010871:Pinealoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D013116:Spinal Cord / Q000473:pathology; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000134:cerebrospinal fluid*
D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins