Germinoma involving the basal ganglia in children |
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Authors: | Tai-Tong Wong Y W Chen Wan-Yuo Guo Kai-Ping Chang Donald M Ho Sang-Hue Yen |
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Institution: | (1) Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, No. 210, Sec 2, Shih-Pai, Taipei, Taiwan, 11217, Republic of China;(2) Cancer Center, School of Medicine, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan, Republic of China;(3) Department of Radiology, School of Medicine, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan, Republic of China;(4) Department of Pediatrics, School of Medicine, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan, Republic of China;(5) Division of Neuropathology, Department of Pathology, School of Medicine, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan, Republic of China |
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Abstract: | Background Germinoma originating in the basal ganglia is rare, and the majority of reported papers have been from Japan. In a collection
of the first 500 cases of primary brain tumors in children in Taipei Veterans General Hospital, six pure germinomas with tissue
diagnosis situated in this location.
Materials and methods We reviewed the clinical features, neuroimaging studies, tumor markers, management, and outcome of these six patients.
Results All of them were boys. The median age of onset of symptoms was 9.7 years. They uniformly presented with hemiparesis. The average
duration of symptoms before surgical management was 1 year. One patient had bilateral basal ganglia tumors. Serum β-human
chorionic gonadotropin levels was elevated (128 mIU/ml) in one patient. Longitudinal neuroimaging studies in four patients
clearly showed that the tumor arose as a tiny lesion at the lenticular nucleus. Five patients had cysts within tumors. Five
patients received partial, subtotal, to total resection. One patient had stereotactic biopsy of the tumors. Postoperative
primary adjuvant therapies included radiotherapy, chemotherapy alone, and combined chemotherapy and radiotherapy. Five patients
survived, and one patient died of radiation-induced sarcoma with median follow-up period of 13.7 years. Local recurrence was
observed in all of three patients after solitary postoperative chemotherapy.
Conclusions The lenticular nucleus is a significant locus for germinomas and can be bilateral. Although rarely reported in Western countries,
it does exist in Taiwan as well. Treatment of germinomas in this specific location is similar to germinoma in other intracranial
locations. |
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Keywords: | Germinoma Intracranial Basal ganglia Children |
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