[Clinico-pathological features of intracranial germ cell tumors with dissemination or metastasis in childhood]

Abstract

Recently reports of the cases with intracranial germ cell tumor associated with dissemination to the central nervous system are increased since the introduction of CT scan. The authors experienced 8 cases with the dissemination among 19 cases of intracranial germ cell tumor in childhood, and discussed their clinico-pathological features. Before the CT scan era, the authors experienced only one case with dissemination, who was a 11 years-old boy (Case 1) and revealed two cell pattern pinealoma disseminating on the subependymal layer of all ventricles and in the basal cisterns at autopsy. Since the introduction of CT scan, 4 cases were found, who showed periventricular dissemination already at the first admission. Among them three cases revealed tumors in the pineal or suprasellar region and also dissemination of tumors on the wall of the lateral ventricles. The other one (Case 3) did not reveal any tumor at pineal or suprasellar region, but disseminated tumors on the wall of the third and lateral ventricles. Histological appearances of all 4 cases were two cell pattern pinealoma by examination of surgical or CSF materials. Only one case (Case 5) was found spinal dissemination later. All 4 cases were good prognosis. The authors considered that there might be diffuse primary ependymal germ cell tumor besides diffuse metastatic one. In the CT scan era, there were three cases who showed dissemination or metastasis along their clinical courses, but had not showed at the first administration. One (Case 6) of 3 cases showed a tumor at the right thalamus at the first administration. Five years later, the tumor metastasized to the cervical cord and he died.(ABSTRACT TRUNCATED AT 250 WORDS)