Mixed germ cell tumors in septum pellucidum after radiochemotherapy of suprasellar germinoma: de novo metachronous or recurrent neoplasms?
BACKGROUND
Mixed germ cell tumors (GCTs) consisting of a germinoma and a mature teratoma in the septum pellucidum have never been described previously; the patient we present here is the first reported example.


METHODS
This case involves an 18-year-old man who presented with abnormal behavior, impairment in recent memory, and emotional change. Five years ago, he received five cycles of chemotherapy using cisplatin and ectoposide and 24G of local radiotherapy for clinical diagnosis of suprasellar germinoma in another hospital. The tumor was then completely resolute. Magnetic resonance imaging in our hospital revealed a large fatty mass located primarily in the septum pellucidum and some portions of the corpus callosum; a heterogeneous enhancing tumor was observed in the surrounding area. The second tumor was completely removed. The histological diagnosis was mixed GCTs containing the component of a germinoma and a mature teratoma.


CONCLUSIONS
This case is characterized by a second GCT occurring at a different site and with a different histological type, long after complete resolution of suprasellar germinoma. Although it is very difficult to draw conclusions about the correlation between the first and second GCTs, neurosurgeons should always pay attention to the pathological variety and dynamic pathological changes in GCTs once they start to examine and treat them.
Department of Neurosurgery, Wonkwang University College of Medicine, 344-2 Shinyong-dong, Iksan, 570-711, South Korea.
Ki Seong
KS
Eom
Jong Moon
JM
Kim
Tae Young
TY
Kim
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D018237:Germinoma / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000473:pathology / Q000628:therapy; D011878:Radiotherapy; D012688:Septum Pellucidum / Q000473:pathology* / Q000601:surgery