title: The role of chemotherapy in intracranial germinoma: a case report.
abstract: BACKGROUND
  The case of a 29-year-old man with histologically proven simultaneous germinoma (seminoma) of the pineal gland and a stage I embryonal carcinoma of the testis is reported. An intradural metastatic lesion from the pineal germinoma was diagnosed at the level of the first thoracic vertebra. Treatment, after inguinal orchiectomy, was chemotherapy only, rather than conventional radiotherapy for the pineal germinoma.
  
  
  METHODS
  Therapy consisted of bleomycin (B), etoposide (E) and cisplatin (P). MRI was used to assess the effectiveness of BEP chemotherapy.
  
  
  RESULTS
  A complete remission of the pineal gland germinoma and the epidural metastasis was documented after two cycles of BEP chemotherapy and after 15 months of follow-up the patient remains free of relapse.
  
  
  CONCLUSIONS
  The pathogenesis of simultaneously occurring germinoma of the pineal gland and embryonal cell carcinoma of the testis is discussed. The choice of therapy in these circumstances is a matter of debate and the good result of chemotherapy alone in this patient suggest that primary chemotherapy may be the therapy of choice in patients with pineal germinomas.
authors.affiliation: Department of Internal Medicine, University Hospital Maastricht, The Netherlands.
authors.forename: P S
authors.initials: PS
authors.lastname: Hupperets
authors.forename: H F
authors.initials: HF
authors.lastname: Defesche
authors.forename: L M
authors.initials: LM
authors.lastname: de Bruijckere
authors.forename: A
authors.initials: A
authors.lastname: Twijnstra
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018236:Carcinoma, Embryonal / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000473:pathology; D010870:Pineal Gland; D010871:Pinealoma / Q000188:drug therapy* / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin