primary intracranial germinoma

Epidemiology

• most commonly present in 2nd decade of life
• prevalent tumor type in suprasellar region, basal ganglia, thalamus

Pathology

• may be benign, but more often aggressive & invasive
• generally occur within or adjacent to the 3rd ventricle, including pineal region

Microscopic pathology

• histologically identical to testicular seminoma
• uniform cells resembling primitive germ cells
• large vesicular nuclei with prominant nucleoli
• relatively abundanty glycogen rich cytoplasm
• pattern may be sheets, lobules, cords in desmoplastic stroma
• lymphoid or lymphoplasmacytic infiltrates
• possibly scattered syncytiotrophoblastic giant cells
• mitoses present
• necrosis uncommon

Immunophenotype

• mostly positive:
• placental alkaline phosphatase: surface membrane more common
• variable:
  • beta-HCG
  • human placental lactogen
  • cytokeratins

Clinical manifestations

• hypothalamic-pituitary dysfunction
  • diabetes insipidus
• visual field defects
• disturbances in memory or mood
• hydrocephalus

Radiology

• uniformly-enhancing lesions with or without well-defined borders

Management

• surgical excision is treatment of choice
• focal irradiation for non-resectable tumor
• cisplatin-based chemotherapy if radiation therapy not feasible
• tumors generally radiosensitive & chemosensitive
• prognosis is good, 5 year survival is > 85%

More general terms

• primary intracranial germ cell neoplasm
• germinoma

Patient information

primary intracranial germinoma patient information