title: Late recurrence of a pineal germinoma 14 years after radiation and chemotherapy: a case report and review of the literature.
abstract: BACKGROUND
  Intracranial germinomas (IG) are rare and highly curable tumors. The incidence and optimal treatment of recurrences are not well defined.
  
  
  METHODS
  A 34-year-old male was diagnosed with a late recurrence of an IG 14 years after the initial diagnosis and treatment. The diagnosis was complicated by the absence of tumor markers and delayed histological sampling of the lesion. Upon histological confirmation, the patient received 2 cycles of conventional chemotherapy, followed by 2 cycles of highdose chemotherapy and peripheral blood stem cell transplantation. The patient achieved a complete remission on magnetic resonance imaging scan. Consolidating radiation of the involved field was performed after termination of the chemotherapy.
  
  
  CONCLUSIONS
  Limited information on the optimal management of late relapses of IG call for individualized therapeutic approaches. Platinum-based chemotherapy, followed by high-dose chemotherapy and consolidative radiation, appears to be feasible and effective in this situation.
authors.affiliation: Department of Oncology and Hematology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, Germany.
authors.forename: Snjezana
authors.initials: S
authors.lastname: Janjetovic
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: Walter
authors.initials: W
authors.lastname: Fiedler
authors.forename: Thorsten
authors.initials: T
authors.lastname: Frenzel
authors.forename: Gabriele
authors.initials: G
authors.lastname: Calaminus
authors.forename: Friedemann
authors.initials: F
authors.lastname: Honecker
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000175:diagnosis / Q000628:therapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D018237:Germinoma / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D010870:Pineal Gland; D010871:Pinealoma / Q000175:diagnosis / Q000628:therapy*; D020266:Radiotherapy, Conformal; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents