title: Germinoma with syncytiotrophoblastic giant cells recurring 13 years after radiotherapy for a pineal germinoma--case report.
abstract: A 28-year-old man presented with progressive mental deterioration. Thirteen years earlier he had undergone radiation therapy for a pineal germinoma. Neuroimaging showed a homogeneously enhanced mass lesion along the ventricular wall. The cerebrospinal fluid (CSF) level of human chorionic gonadotropin (HCG) was high. Endoscopic biopsy revealed that the tumor was a two-cell pattern germinoma. The diagnosis was germinoma with syncytiotrophoblastic giant cells (STGC). He first received three cycles of chemotherapy with carboplatin and etoposide and then two cycles with ifosfamide, cisplatin, and etoposide. Subsequently, the tumor size decreased markedly and the CSF level of HCG returned to normal. However, he died 22 months after the recurrence. Histological verification and measurement of tumor markers are necessary for the optimum treatment of germ cell tumors. Adequate initial chemotherapy and long-term follow up are essential for patients with germinoma with STGC.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University of Kagoshima, Kagoshima, Japan. fujifuji-k@syd.odn.ne.jp
authors.forename: Koushou
authors.initials: K
authors.lastname: Fujikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hirano
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Niiro
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kuratsu
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D018237:Germinoma / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D015726:Giant Cells / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010870:Pineal Gland; D014327:Trophoblasts / Q000473:pathology*