Recurrent pure CNS germinoma with markedly elevated serum and cerebrospinal fluid human chorionic gonadotropin-beta (HCGβ).
Controversy continues regarding what level of serum and/or cerebrospinal fluid (CSF) human chorionic gonadotrophin-beta (HCGβ) is consistent with pure germinoma of the central nervous system (CNS). We report a 10-year female with biopsy-proven pure germinoma and normal serum and CSF HCGβ who experienced subsequent biopsy-proven recurrences of germinoma. At recurrence, serum and CSF HCGβ levels were 560 and 3,202 mIU/ml, respectively, although final autopsy demonstrated pure germinoma. This case illustrates the need to re-evaluate the assumption that pathologically pure germinomas may be associated with high levels of HCGβ which are unrelated to nongerminomatous germ cell tumor (NGGCT)/choriocarcinomatous elements.
Neural Tumors Program, Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles, Los Angeles, CA, USA. soumen.khatua@imail.org
Soumen
S
Khatua
Andrew
A
Phillips
Jason
J
Fangusaro
Sally
S
Bovan
Girish
G
Dhall
Jonathan L
JL
Finlay
D001932:Brain Neoplasms / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*; D002648:Child; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood* / Q000134:cerebrospinal fluid*; D017809:Fatal Outcome; D005260:Female; D018237:Germinoma / Q000097:blood / Q000134:cerebrospinal fluid / Q000209:etiology*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis
D018997:Chorionic Gonadotropin, beta Subunit, Human