[Primitive intracranial trigeminal nerve germinoma. Case report].
A 22-year-old man presented headache, asthenia, body weight loss and trigeminal hypoesthesia worsening quickly. Radiological analysis showed an enhanced lesion that originated from the cavernous sinus and extended into the Meckel cave, owing to the fifth cranial nerve's course. The lesion was explored by a temporo-pterional approach and was partially removed. On the basis of histological analysis and negativity of tumor marker levels in serum and cerebrospinal fluid (alpha-fetoprotein alpha, human beta-chorionic gonadotropin), a primitive non-secreting intracranial germinoma was diagnosed. Under combined chemotherapy (carboplatine, ifosfamide, etoposide) followed by focal fractionated radiotherapy delivering 40 Gy to the initial tumor volume, the outcome was excellent. Five years later, the patient was in complete clinical and radiological remission. Primitive intracranial germinomas are rare malignant tumors involving mainly pineal and hypothalamic regions. We report a case of intracranial trigeminal nerve germinoma. To the best of our knowledge, no case of primitive germinoma was previously described in this location. Aspects of diagnosis and treatment are discussed in the light of previous publishing data.
Baussart
B
B
Service de neurochirurgie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France. bertranbaussart@yahoo.fr
Lepeintre
J-F
JF
Condette-Auliac
S
S
Dupuy
M
M
Gaillard
S
S
D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology; D003131:Combined Modality Therapy; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D018237:Germinoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D010292:Paresthesia / Q000209:etiology; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*