The necessity of long-term follow-up including spinal examination after successful initial treatment of intracranial germinoma: case reports.
BACKGROUND
Intracranial germinomas seldom recur at spinal space following whole-brain or whole-ventricular (WV) radiotherapy. The majority of the spinal recurrence takes place within 5 years after treatment; therefore, late spinal failure beyond 5 years after successful initial treatment is rare.


METHODS
We describe the cases of two patients with intracranial germinoma, who developed spinal recurrence 7 and 9 years after the initial treatment with WV radiotherapy combined with and without chemotherapy, respectively. In both cases, spinal recurrent tumors were histologically diagnosed as germinoma and they were successfully treated with chemotherapy and local radiotherapy without tumor recurrence for 11 years and 11 months, respectively.


CONCLUSIONS
Intracranial germinomas may potentially present with spinal recurrence many years after successful initial WV radiotherapy. Physicians must be aware of patients' symptoms during the clinical examination. Regular long-term monitoring, including spinal examination, is necessary for 5-10 years or longer.
Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Makoto
M
Ohno
Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. yonarita@ncc.go.jp.
Yoshitaka
Y
Narita
Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Yasuji
Y
Miyakita
Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Soichiro
S
Shibui
D000328:Adult; D000359:Aftercare; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D059248:Chemoradiotherapy; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D013120:Spinal Cord Neoplasms / Q000556:secondary*
Germinoma; Intracranial; Late recurrence; Spinal recurrence; Whole-ventricular radiotherapy