Germinoma with synchronous lesions in the pineal and suprasellar regions

Lester Lee, Frank Saran, Darren Hargrave, István Bódi, Sanj Bassi, T. Hortobágyi

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Germinomas represent the most frequent tumour type in the pineal region and the synchronous involvement of the suprasellar region, frequently termed bifocal disease, is increasingly recognised. The incidence, pathogenesis, histomorphological, radiological, clinical features, and management strategies are discussed. Case report: A 6-year-old girl presented with clinical features of hypothalamic-pituitary axis dysfunction. MRI showed two distinct lesions in the pineal and suprasellar regions. Tumour markers for germ cell tumours from blood and cerebrospinal fluid were within the normal range. The suprasellar lesion was biopsied and the histology revealed a germinoma. She received a radical course of radiotherapy covering the entire craniospinal axis (24 Gy/15#) followed by focal boost to the sites of primary disease (16 Gy/10#). Three months after the completion of treatment, the patient achieved a complete clinical and radiological response, which was maintained during the 13-month follow-up period. Conclusions: The optimum management of primary intracranial pineal and suprasellar (bifocal) germinomas still remains controversial. The definition as either localised or disseminated disease has major implications on required treatment and its associated late morbidity. Prospective studies with large cooperative groups worldwide and consensus meetings may reduce uncertainties regarding available management options.

Original languageEnglish
Pages (from-to)1513-1518
Number of pages6
JournalChild's Nervous System
Volume22
Issue number12
DOIs
Publication statusPublished - Dec 2006

Fingerprint

Germinoma
Pinealoma
Germ Cell and Embryonal Neoplasms
Tumor Biomarkers
Uncertainty
Cerebrospinal Fluid
Histology
Reference Values
Radiotherapy
Prospective Studies
Morbidity
Incidence
Therapeutics

Keywords

  • Germcell tumour
  • Germinoma
  • Intracranial
  • Pineal
  • Radiotherapy
  • Suprasellar

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Germinoma with synchronous lesions in the pineal and suprasellar regions. / Lee, Lester; Saran, Frank; Hargrave, Darren; Bódi, István; Bassi, Sanj; Hortobágyi, T.

In: Child's Nervous System, Vol. 22, No. 12, 12.2006, p. 1513-1518.

Research output: Contribution to journalArticle

Lee, Lester ; Saran, Frank ; Hargrave, Darren ; Bódi, István ; Bassi, Sanj ; Hortobágyi, T. / Germinoma with synchronous lesions in the pineal and suprasellar regions. In: Child's Nervous System. 2006 ; Vol. 22, No. 12. pp. 1513-1518.
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