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. 2012 Oct;7(4):197-202.
doi: 10.4103/1793-5482.106652.

Primary intracranial germ cell tumors

Shagufta Tahir Mufti  1 , Awatif Jamal
Affiliations

Primary intracranial germ cell tumors

Shagufta Tahir Mufti et al. Asian J Neurosurg. 2012 Oct.

Abstract

Background: Primary intracranial germ cell tumors are rare (ICGCTs) and usually localized in the pineal and suprasellar regions of the brain. They are divided into histologic types: Germinoma, teratoma choriocarcinoma, embryonal carcinoma, yolk sac tumor, and malignant mixed germ cell tumors (MMGCTs). Neuroimaging evaluation is useful to distinguish between the types of ICGCTs. Germinoma is highly sensitive to radiotherapy or/and chemotherapy, and is potentially curable without surgery. MMGCTs are treated with the combination of chemotherapy and radiation, with a poorer prognosis. ICGCTs warrant correct pre-operative diagnosis in order to decide on appropriate management.

Aim: To report the clinicopathological and immunohistochemical findings in three cases of primary intracranial germ-cell tumor.

Materials and methods: Three cases of intracranial germ cell tumors inclusive of both genders and all brain regions were retrieved from the archives of the Anatomical Pathology Department at King Abdul Aziz University Hospital, Jeddah between the years, 1995-2011, through a computerized search.

Results: Based on histological examination, they were respectively diagnosed as MMGCTs (two cases) and germinoma. Clinical, radiological, pathological characteristics and immunohistochemical profile of the three ICGCTs are presented along with the review of recent literature.

Conclusion: ICGCTs are rare tumors affecting males more than females, and at the end of three years follow-up in the present study, treatment morbidity appears to be low with no recurrence observed among surviving patients, indicating that suprasellar and basal ganglia ICGCTs may have a favorable prognosis regardless of histological type. Pineal MMGCTs may have an aggressive course.

Keywords: Germinoma; immunohistochemical; intracranial; mixed; pineal.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Suprasellar MMGCT, ×40; showing germinoma component. Cells with high N C ratio with defined cell borders and sprinkling of lymphocytes; (b) Suprasellar MMGCT, ×40; showing germinoma component admixed with glandular structures of yolk sac origin; (c) Suprasellar MMGCT, ×40; showing CD-117 positivity in germinoma component; (d) Suprasellar MMGCT, ×40; showing CK-PAN positivity in glandular structures of yolk sac origin. Note the negative germinoma cells in between; (e) Suprasellar MMGCT, ×40; showing AFP positivity in yolk sac component
Figure 2
Figure 2
(a) Basal ganglia germinoma, ×40; cells with high N C ratio with defined cell borders and surrounded by lymphocytes (b) note the glial tissue on the left side
Figure 3
Figure 3
(a) Pineal MMGCT, ×40; showing reticular pattern of yolk sac elements (b) showing immature epithelial elements
See this image and copyright information in PMC

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