title: Mixed germ cell tumors with abundant sarcomatous component in the temporal lobe after radiochemotherapy of neurohypophyseal germinoma: a case report.
abstract: We report a case of intracranial germ cell tumor that showed pathological changes from neurohypophyseal germinoma to mixed germ cell tumors consisting exclusively of undifferentiated sarcomatous component after radiochemotherapy. Three surgical specimens and autopsied brain from the patient were histologically examined. An initial specimen from the neurohypophyseal tumor was diagnosed as germinoma with a two-cell pattern. Five years later, after repeated radiochemotherapy, the second specimen resected from the right temporal lobe showed mixed germ cell tumors consisting of the three components of germinoma, choriocarcinoma, and immature teratoma. Six months later after intensive radiotherapy, the right temporal tumor recurred and was surgically removed. The histological diagnosis was mixed germ cell tumors with abundant immature teratoma component. The patient died of uncontrollable tumor growth with repeated intratumoral hemorrhages. The autopsied brain showed sarcoma with angionecrosis. This pathological alteration indicated an increase in the sarcomatous component after undergoing various treatments. We discuss the histological changes of intracranial germ cell tumor modified by treatment.
authors: Department of Neurosurgery, Tottori University, Yonago, 683-8504, Japan. kamitani@grape.med.tottori-u.ac.jp
authors: Hideki
authors: H
authors: Kamitani
authors: Hajime
authors: H
authors: Miyata
authors: Minako
authors: M
authors: Ishibashi
authors: Masamichi
authors: M
authors: Kurosaki
authors: Minoru
authors: M
authors: Mizushima
authors: Keiichi
authors: K
authors: Akatsuka
authors: Eisaku
authors: E
authors: Ohama
authors: Takashi
authors: T
authors: Watanabe
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000473:pathology*; D002822:Choriocarcinoma / Q000473:pathology; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D018237:Germinoma / Q000473:pathology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology*; D016612:Paraffin Embedding; D010904:Pituitary Gland, Posterior / Q000473:pathology; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D012509:Sarcoma / Q000473:pathology*; D013702:Temporal Lobe / Q000473:pathology*; D013724:Teratoma / Q000473:pathology; D016707:Tissue Fixation