[A case of pineal pure germinoma metastasized to the lumbosacral extradural space 8 years after initial therapy. Case report and review of literature].
An 11-year-old boy first presented with a pineal tumor identified by neuroimaging but without positive serum or cerebrospinal fluid markers. The tumor disappeared after the craniotomy and following cranial irradiation. The pathologic diagnosis of the tumor was of a pure germinoma. Eight years later he returned to the hospital with spinal epidural metastasis from the pineal germinoma and required surgery. Intraoperative findings showed that the spinal tumor was solitarily located in the epidural space. Pathologically the tumor was a pure germinoma metastasis. He was treated by a combination of whole spinal irradiation and chemotherapy. The tumor disappeared after the therapy. A pineal germinoma occasionally disseminates through the ventricular system and spinal subarachnoid region. However, a solitary spinal epidural metastasis from pineal germinoma has rarely been reported. Regarding the route of this metastasis, we speculate that the CSF dissemination of the germinoma cells occurred first and some of those cells were trapped in the spinal nerve sleeve and extended into the epidural space.
Miyoshi
Yasuyuki
Y
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama-city, Okayama 700-8558, Japan.
Omori
Masako
M
Kobayashi
Nobuyuki
N
Masuko
Toshihiro
T
Watanabe
Eiju
E
Date
Isao
I
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D004334:Drug Administration Schedule; D004824:Epidural Space; D005047:Etoposide / Q000008:administration & dosage; D018237:Germinoma / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery; D008161:Lumbosacral Region / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010871:Pinealoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*
D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide