Central nervous system germinomas. A review
M. B. Horowitz and W. A. Hall
Department of Neurological Surgery, University of Pittsburgh, School of Medicine, PA.
The germinoma represents a less malignant form of germ cell tumor.
Depending on the individual's age, this neoplasm constitutes approximately
0.1% to 3.4% of all intracranial tumors. The embryologic origin remains a
mystery; however, current theories implicate an aberration in primordial
germ cell migration. Clinical presentation depends on tumor location and
may involve endocrine, hypothalamic, visual, and cognitive dysfunction. In
evaluating midline intracerebral masses, it is imperative that one be aware
of the various radiologic appearances, endocrinologic changes, and chemical
markers that help to distinguish germinomas from other neoplasms that
appear in the pineal, suprasellar, and periventricular regions. Only
through the careful evaluation of all available studies can the physician
institute appropriate therapies such as biopsy, radiation, and
chemotherapy. This article focuses on the epidemiology, embryology,
clinical presentation, means of diagnosis, treatment, and outcome of this
rare neoplasm.
