Occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor containing yolk sac tumor and germinoma.
The authors report a rare case involving the occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor (GCT) categorized as having a poor prognosis. A neurohypophysial germinoma occurred 4 years and 6 months after the initial treatment of a mixed pineal GCT containing a yolk sac tumor and a germinoma. Furthermore, intramedullary germinomas occurred 21 years after the initial treatment of the mixed GCT and 15 years after the second treatment of the neurohypophysial germinoma. The neurohypophysial germinoma was not confirmed histopathologically, but the intramedullary germinoma was histopathologically diagnosed as a pure germinoma. Serum α-fetoprotein levels at the second neurohypophysial and third intramedullary occurrences of the germinomas were less than 10 ng/ml. Therefore, no yolk sac components seemed to be contained in the tumors. The second neurohypophysial and third intramedullary germinomas might be recurrences of the germinoma component of the pineal mixed GCT, which consisted of a yolk sac tumor and a germinoma. However, it seems very unlikely that only the germinoma, categorized in the good prognosis group, would be the only one to recur. Hence, it seems plausible that both the second and the third occurrences of pure germinoma were de novo metachronous GCTs arising after the pineal mixed GCT was cured. The authors' case indicates the possibility of multicentric GCTs in the CNS.
Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan. jinguji@bri.niigata-u.ac.jp
Shinya
S
Jinguji
Kouichirou
K
Okamoto
Junichi
J
Yoshimura
Yuichiro
Y
Yoneoka
Ryousuke
R
Ogura
Akihiko
A
Saito
Yukihiko
Y
Fujii
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D018237:Germinoma / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D010871:Pinealoma / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000628:therapy; D011506:Proteins / Q000235:genetics; D014057:Tomography, X-Ray Computed; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
D011506:Proteins; D000509:alpha-Fetoproteins; C055324:phospholipase A2-activating protein