Primary Spinal Germ Cell Tumors: A Case Analysis and Review of Treatment Paradigms

نویسندگان

  • Joshua J. Loya
  • Henry Jung
  • Caroline Temmins
  • Nam Cho
  • Harminder Singh
چکیده

Objective. Primary intramedullary spinal germ cell tumors are exceedingly rare. As such, there are no established treatment paradigms. We describe our management for spinal germ cell tumors and a review of the literature. Clinical Presentation. We describe the case of a 45-year-old man with progressive lower extremity weakness and sensory deficits. He was found to have enhancing intramedullary mass lesions in the thoracic spinal cord, and pathology was consistent with an intramedullary germ cell tumor. A video presentation of the case and surgical approach is provided. Conclusion. As spinal cord germinomas are highly sensitive to radiation and chemotherapy, a patient can be spared radical surgery. Diverse treatment approaches exist across institutions. We advocate biopsy followed by local radiation, with or without adjuvant chemotherapy, as the optimal treatment for these tumors. Histological findings have prognostic value if syncytiotrophoblastic giant cells (STGCs) are found, which are associated with a higher rate of recurrence. The recurrence rate in STGC-positive spinal germinomas is 33% (2/6), whereas it is only 8% in STGC-negative tumors (2/24). We advocate limited volume radiotherapy combined with systemic chemotherapy in patients with high risk of recurrence. To reduce endocrine and neurocognitive side effects, cranio-spinal radiation should be used as a last resort in patients with recurrence.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

A Case Report of Giant Cell Tumor of the Tendon Sheath after Treatment of Germ Cell Tumor of Testicles in a 7-year-old boy

Germ cell tumors account for 2 to 3% of all cancers in children. These tumors appear in the testicles as painless masses. The primary treatment of these tumors is the removal of testicles and chemotherapy. Giant cell tumor of the tendon sheath (GCTTS) is slow-growing tumor and the primary treatment of this tumor is surgery and both surgery and radiotherapy in invasive type. This report presents...

متن کامل

A novel case of quartet tumor: meningioma, angiomyolipoma, ependymoma and sarcoma: report of a case and review of the literature

Multiple primary tumors in a single patient are relatively rare when four or more distinct lesions are considered. Herein, we report a case of woman with four different primary tumors: meningioma, renal angiomyolipoma, spinal ependymoma and high-grade soft tissue sarcoma. There was no family history and hereditary syndrome. The genetic analysis was completely normal. To best of our knowledge, t...

متن کامل

Survival of Children with Germ Cell Tumors in Ali Asghar Hospital since 1990 to 2003

Background and Objective: Germ cell tumor (GCT) accounts for approximately 2-3% of all malignancies in children. In this respect, about 20% of patients with GCT are still resistant to therapy. Materials and Methods: The cross-sectional strategy of this survey was undertaken on 57 patients with germ cell ...

متن کامل

Concomitant Primary Cerebral Lymphoma and Meningioma: Report of a Case and Review of Literature

Primary central nervous system lymphoma (PCNSL) is a rare cancer that confined to the brain, spinal cord, leptomeninges and eyes. The origin of this type of lymphoma is often type B lymphocytes, and because the central nervous system (CNS) has no lymph nodes or lymphatic vessels, the cause of PCNSL is still uncertain (1). But its source appears to be from lymphocytes located in the CNS (2). Thi...

متن کامل

P-174: Good Pregnancy Outcome after Prenatal Exposure to Bleomycin, Etoposide and Cisplatin for Ovarian Immature Teratoma: A Case Report and Literature Review

Background: The administration of bleomycin plus etoposide and cisplatin during pregnancy is rare. Materials and Methods: We describe a case with good pregnancy outcome after exposure to these chemotherapeutic agents at the third trimester of pregnancy. Results: Pregnant woman with stage IIIc immature teratoma underwent surgical staging, and received two cycles of bleomycin, etoposide and cispl...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 2013  شماره 

صفحات  -

تاریخ انتشار 2013