title: Mixed pineal mature teratoma and germinoma in two brothers of the fraternal triplets.
abstract: BACKGROUND
  Intracranial teratomas are rare germ cell neoplasms that contain tissues derived from all three germ cell layers and most commonly occurring during childhood. This is the first report of pineal region mixed mature teratoma and germinoma in two fraternal brothers of fraternal triplets.
  
  
  METHODS
  We report the case of a mixed mature teratoma and germinoma of the pineal region in two brothers of fraternal triplets. Older brother was initially diagnosed at the age of 11 years with the pure teratoma of the pineal region but the review of the pathology 3 years after initial surgery revealed the mixed mature teratoma with 5% germinomatous component. The younger brother was diagnosed at the age of 13 years with the mixed mature teratoma with 10% germinomatous component tumor of the pineal region. Younger brother has been treated with adjuvant chemo-radiotherapy and older brother was treated without adjuvant therapy. Both brothers had no recurrence.
  
  
  CONCLUSIONS
  Pineal mature teratomas have a good prognosis, in contrast to their immature or mixed counterparts. A rigorous histological examination of the tumor samples is mandatory, in order to not omit a mixed contingent within the tumor.
authors.affiliation: Division of Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA. gordan.grahovac@gmail.com.
authors.forename: Gordan
authors.identifier: http://orcid.org/0000-0001-7255-8853
authors.initials: G
authors.lastname: Grahovac
authors.affiliation: Division of Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
authors.forename: Tord
authors.initials: T
authors.lastname: Alden
authors.affiliation: Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, 60611, USA.
authors.forename: Wadhwani
authors.initials: W
authors.lastname: Nitin
mesh_terms: D000293:Adolescent; D002648:Child; D018237:Germinoma / Q000000981:diagnostic imaging* / Q000235:genetics; D006801:Humans; D008297:Male; D010871:Pinealoma / Q000000981:diagnostic imaging* / Q000235:genetics; D035781:Siblings; D013724:Teratoma / Q000000981:diagnostic imaging* / Q000235:genetics; D014310:Triplets / Q000235:genetics
keywords: Brain tumors; Germinoma; Pineal tumors; Teratoma; Twins