[Sellar germinoma with lung metastases]

Abstract

Reported in this paper is the case of a boy aged 15 years with sellar germinoma which led to one singular pulmonary metastasis, three years after subtotal surgical removal and subsequent successful irradiation of the tumor rest. The primary tumor together with the lung metastasis were characterised as germinoma with trophoblastic giant cells as additional elements. Interpretation of the pulmonary tumour was somewhat difficult, since diagnosis of the primary tumor had encouraged assumption of a chromophobic hypophyseal adenoma with polymorphic manifestation, with no relationship between the intracranial and pulmonary tumors being presumed by the surgeon. The true nature of the metastasis and, consequently, the histogenetic identity of both tumors was cleared up by immunohistochemical detection of beta-HCG in almost all syncytiotrophoblasts. Comprehensive analysis of the literature on metastasising intracranial germinomas may be helpful in disclosing possible relationships between the histological type of a primary tumor or neurosurgical action and the metastatic potential of tumors.