title: [A mixed germ cell tumor that underwent dramatic size changes].
abstract: This report describes a mixed germ cell tumor that underwent dramatic size changes. A 12-year-old boy presented to our hospital with a headache that had persisted for two months. Initial magnetic resonance imaging (MRI) revealed a pineal tumor and hydrocephalus. The patient required external ventricular drainage and underwent two endoscopic biopsies. His evaluation involved a total of nine computed tomography (CT) scans prior to the second biopsy;the tumor size had decreased before the second endoscopic biopsy. The tumor consisted of both a germinoma and a teratoma component. The patient was treated with three courses of carboplatin-etoposide (CBDCA-VP) chemotherapy and whole-ventricle radiotherapy (32.1 Gy). However, during the adjuvant therapy, the tumor size increased, necessitating total tumor resection. We speculate that the tumor's initial size reduction was caused by leakage of the cyst component and exposure to the brain CT irradiation. The tumor's subsequent increase in size was due to the recollection of the cystic components and intracranial growing teratoma syndrome (iGTS). Therefore, frequent brain CTs and angiography should be avoided before definitive pathological diagnosis is achieved. Further, the tumor size should be considered, with surgical resection being performed at the optimal time.
authors.affiliation: Department of Neurosurgery, Kawasaki Medical School.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kuwayama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takai
authors.forename: Akira
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirai
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Yokosuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Toi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirano
authors.forename: Shunji
authors.initials: S
authors.lastname: Matsubara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uno
authors.forename: Hirotake
authors.initials: H
authors.lastname: Nishimura
mesh_terms: D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000628:therapy; D002533:Cerebral Angiography; D002648:Child; D003131:Combined Modality Therapy; D018237:Germinoma / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013724:Teratoma / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed