Intracranial Germ Cell Tumors – A Case Series

Abstract

Background: Intracranial germ cell tumors originate from extragonadal seminal cells and have been found in 0.4–3.4 % of patients with primary CNS tumors in Western countries, while the incidence is reported to be 5–8 times greater in Japan and the Far East. They occur mainly in the pediatric or young adult populations. The aim of this study is to review the outcome of patients harboring intracranial germ cell tumors after therapy.

Methods: We conducted a retrospective review of the medical records of patients having intracranial germ cell tumors who were treated in our division between January 2000 and November 2016. Their age, sex, initial presentation, tumor locations, pathology, treatment modalities, tumor dissemination or tumor progression, duration of follow-up, and outcome were reviewed.

Results: There were 16 consecutive patients (9 males and 7 females) having intracranial germ cell tumors treated in our division between January 2000 and November 2016. Their mean age at diagnosis was 22.81 years. 11 patients (68.75%) got germinomas; 2 patients (12.5%) got mixed germ cell tumors; 1 patient (6.25%) got yolk sac tumor; 1 patient (6.25%) got mature teratoma and 1 patient (6.25%) did not have tissue diagnosis but was diagnosed by imaging findings and tumor markers (high level of alpha fetoprotein and beta human chorionic gonadotropin). 8 patients (50%) had to undergo ventriculoperitoneal shunting procedure to release the obstructive hydrocephalus. 3 patients (18.75%) had tumor progression or dissemination during follow-up. 11 patients (68.75%) had favourable outcome, 2 patients (12.5%) had unfavourable outcome and 3 patients (18.75%) were expired.

Conclusions: Most intracranial germ cell tumors are chemo-radiosensitive. Either chemotherapy or radiotherapy or the combination are the backbone of therapy to the intracranial germ cell tumors. Surgery plays a role to get tissue diagnosis and to resolve the obstructive hydrocephalus if present.