Recurrent intracranial germinoma along the endoscopic ventriculostomy tract. Case report.
The authors report a case of a recurrent intracranial germinoma along the site of an endoscopic third ventriculostomy (ETV) after complete local tumor control using 3D conformal radiation therapy. A 13-year-old girl presented with sudden left upward gaze limitation for 4 days. A pineal region tumor and obstructive hydrocephalus were noted on magnetic resonance (MR) images. An ETV and tumor biopsy procedure were performed, which revealed the lesion to be a germinoma. The patient's visual symptoms and hydrocephalus disappeared postoperatively. Chemotherapy using cisplatin, etoposide, vincristine, and cyclophosphamide was initiated on postoperative Day 10. An MR image obtained 10 weeks after surgery and 2 weeks after chemotherapy revealed a significant (> 50%) reduction of the lesion. Radiation therapy was administered at 50.4 Gy to the target and 36 Gy to the periphery. Ten months after surgery, an MR image revealed further shrinkage of the tumor mass. One year after surgery, follow-up MR imaging demonstrated a small mass lesion at the entry site of the ETV, measuring 1.0 x 1.4 x 1.5 cm. An operation was performed to remove the small lesion, and pathological findings revealed it to be of the same histology as the primary tumor.
Choi
Ung Kwan
UK
Departments of Neurosurgery, School of Medicine, Pusan National University, Pusan, Republic of Korea.
Cha
Seung Heon
SH
Song
Geun Sung
GS
Choi
Chang Hwa
CH
Lee
Sang Weon
SW
Lim
Young Tak
YT
Kim
Won Taek
WT
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002551:Cerebral Ventricle Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004724:Endoscopy; D005260:Female; D018237:Germinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D009366:Neoplasm Seeding; D009460:Neurologic Examination; D010871:Pinealoma / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D020542:Third Ventricle; D014696:Ventriculostomy