title: Primary Intracranial Germinomas: Retrospective Analysis of Five Cases.
abstract: OBJECTIVE
  Primary intracranial germinomas (PIGs) are rare malignant brain tumors that represent approximately 0.2% to 1.7% of all primary intracranial tumors. PIGs have infrequent, but there is a possibility of spinal cord metastases. In this study, clinical outcomes of five consecutive PIGs have been presented.
  
  
  METHODS
  Medical records were retrospectively reviewed in 1,849 cases of intracranial tumors who underwent surgery between the years 2005 and 2015 and cases confirmed as germinoma histopathologically were included in this study.
  
  
  RESULTS
  Five cases of PIGs were detected in two female (40%) and 3 male (60%) patients. The mean age was 15.2±5.6 (8-23) years. The mean follow-up period was 52.3±56.4 (9-135) months. The most common complaint was headache (60%), followed by nausea±vomiting (40%). Four cases (80%) affected the suprasellar region while the fifth patient"s tumor was localized in the pineal region. The duration between the initial symptom and time of surgical intervention ranged between 15 days and 2 months. Twelve months after the first operation, one patient presented with drop seeding metastasis. Four-year survival (with exception of the case that died as a early surgical complication) was 100%. Gross total resection (GTR) was achieved in one patient. Surgical mortality rate was 20%. PIGs" morbidity rate was 60%.
  
  
  CONCLUSIONS
  PIG is a mostly malignant tumor that generally affects the pediatric age group. They are radiosensitive tumors. Subtotal or near-total resection using stereotactic guide or direct surgery to confirm the histopathological diagnosis followed by chemotherapy and whole brain or in some cases craniospinal radiotherapy rather than GTR is therefore the treatment of choice.
authors.affiliation: Bakirkoy Research and Training Hospital for Neurology Neurosurgery and Psychiatry, Department of Neurosurgery, Istanbul, Turkey.
authors.forename: Anas
authors.initials: A
authors.lastname: Abdallah
authors.forename: Murad
authors.initials: M
authors.lastname: Asilturk
authors.forename: Mustafa Levent
authors.initials: ML
authors.lastname: Uysal
authors.forename: Erhan
authors.initials: E
authors.lastname: Emel
authors.forename: Betul Guler
authors.initials: BG
authors.lastname: Abdallah
authors.forename: Bilge
authors.initials: B
authors.lastname: Bilgic
authors.forename: Gokcen
authors.initials: G
authors.lastname: Gundogdu
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D002648:Child; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D018237:Germinoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006261:Headache / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult