Germinoma

Magnetic resonance imaging of a germinoma of the pineal region. T1 weighting with contrast agent.

A germinoma is a germ cell tumor of the central nervous system (CNS). Its histology corresponds to the dysgerminoma in the ovaries and the seminoma of the testicle . Over 75% of patients are between 10 and 20 years old at the time of diagnosis. The tumor usually responds very well to radiation or chemotherapy.

forecast

The 5-year survival rate is 90%.

Diagnosis

In well over 80% the tumor is located in the midline in the area of the pinealis , but up to 5% of the tumors can be multifocal. The diagnosis is usually made through a biopsy . The determination of beta-HCG and AFP in the cerebrospinal fluid is also groundbreaking.

histology

Histological picture of a germinoma in HE staining .

The germinome is characterized by a planar cohesive growth. The large tumor cells with clear cytoplasm often have prominent nucleoli and are divided into lobules by septa. These septa are usually filled with numerous lymphocytes . Syncytiotrophoblasts (beta-HCG positive) are also observed in a rare, but prognostically unfavorable subtype . The tumor cells can be identified immunohistochemically by their expression of placental alkaline phosphatase (PLAP), C-Kit , Oct-4 and, in rare cases, cytokeratin .

treatment

Combined radiation therapy and chemotherapy with carboplatin , etoposide or bleomycin is curative.

Individual evidence

^ RJ Packer, BH Cohen, K. Cooney, K. Coney: Intracranial germ cell tumors . In: Oncologist . tape 5 , no. 4 , 2000, pp. 312-320 , PMID 10964999 .
↑ D. Keene, D. Johnston, D. Strother et al .: Epidemiological survey of central nervous system germ cell tumors in Canadian children . In: J. Neurooncol. tape 82 , no. 3 , 2007, p. 289-295 , doi : 10.1007 / s11060-006-9282-2 , PMID 17120159 .
↑ T. Ueba, K. Yamashita, L. Fujisawa et al .: Long-term follow-up of 5 patients with intracranial germinoma initially treated by chemotherapy alone . In: Acta Neurochirurgica . tape 149 , no. 9 , 2007, p. 897-902; discussion 902 , doi : 10.1007 / s00701-007-1268-0 , PMID 17690837 .
^ C. Balmaceda, G. Heller, M. Rosenblum et al .: Chemotherapy without irradiation - a novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. The First International Central Nervous System Germ Cell Tumor Study . In: J. Clin. Oncol. tape 14 , no. 11 , 1996, pp. 2908-2915 , PMID 8918487 .

[1] RJ Packer, BH Cohen, K. Cooney, K. Coney: Intracranial germ cell tumors . In: Oncologist . tape 5 , no. 4 , 2000, pp. 312-320 , PMID 10964999 .

[2] D. Keene, D. Johnston, D. Strother et al .: Epidemiological survey of central nervous system germ cell tumors in Canadian children . In: J. Neurooncol. tape 82 , no. 3 , 2007, p. 289-295 , doi : 10.1007 / s11060-006-9282-2 , PMID 17120159 .

[pmid17690837-3] T. Ueba, K. Yamashita, L. Fujisawa et al .: Long-term follow-up of 5 patients with intracranial germinoma initially treated by chemotherapy alone . In: Acta Neurochirurgica . tape 149 , no. 9 , 2007, p. 897-902; discussion 902 , doi : 10.1007 / s00701-007-1268-0 , PMID 17690837 .

[pmid8918487-4] C. Balmaceda, G. Heller, M. Rosenblum et al .: Chemotherapy without irradiation - a novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. The First International Central Nervous System Germ Cell Tumor Study . In: J. Clin. Oncol. tape 14 , no. 11 , 1996, pp. 2908-2915 , PMID 8918487 .