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Central Nervous System Germ Cell Tumor

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Tumors of the Central Nervous System, Volume 4

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 4))

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Abstract

Central nervous system germ cell tumors (CNSGCTs) are tumors of children and young adults. They affect mainly the pineal body, neurohypophysis (“suprasellar” area) and basal ganglia, but can arise in any other CNS location. Histologically, they are divided into germinoma and non-germinomatous germ cell tumors (NGGCTs), the latter including teratoma, embryonal carcinoma, choriocarcinoma, and yolk sac tumor. Teratomas are further subclassified into mature teratoma, immature teratoma, and teratoma with malignant transformation. Except for mature teratoma, all of these tumors are biologically malignant. Histologically, they resemble reproductive cells, fetal tissues, or related tissues such as placenta, and mixtures of these tumor subcategories are not rare. Initial symptoms include increased intracranial pressure due to obstructive hydrocephalus, abnormality of ocular movement and endocrine disorders. Some tumors of these subclasses produce humoral tumor markers, beta-human chorionic gonadotropin, alpha-fetoprotein or other markers, which can be used for differential diagnosis or clinical follow-up. Only mature teratoma can be cured with surgery alone, and the other tumors require adjuvant therapy for complete remission. Germinomas respond well to irradiation and can be cured, but platinum-based chemotherapy combined with reduced-dose irradiation has been recently used to minimize radiation-related toxicities or complications. As the other tumors cannot be cured by irradiation alone, more intensive platinum-based chemotherapy and radiation therapy including whole-neuroaxis irradiation are employed. Although better disease control and longer survival can now be achieved, the results of treatment are still not satisfactory. Therefore, development of new treatments, and improvements to existing ones, are needed for CNSGCTs.

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References

  • Berek K, Aichner F, Schmutzhard E, Kofler M, Langmayr F, Gerstenbrand F (1991) Intracranial germ cell tumor mimicking anorexia nervosa. Klin Wochenschr 69:440–442

    Article  PubMed  CAS  Google Scholar 

  • Calaminus G, Bamberg M, Jurgens H, Kortmann RD., Sorensen N, Wiestler OD, Gobel U (2004) Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89. Klin Padiatr 216:141–149

    Article  PubMed  CAS  Google Scholar 

  • Eom KY, Kim IH, Park CI, Kim HJ, Kim JH, Kim K, Kim SK, Wang KC, Cho BG, Jung HW, Heo DS, Kang HJ, Shin HY, Ahn HS (2008) Upfront chemotherapy and involved-field radiotherapy results in more relapses than extended radiotherapy for intracranial germinomas: modification in radiotherapy volume might be needed. Int J Radiat Oncol Biol Phys 71:667–671

    Article  PubMed  CAS  Google Scholar 

  • Friedman NB (1947) Germinoma of the pineal; its identity with germinoma (seminoma) of the testis. Cancer Res 7:363–368

    PubMed  CAS  Google Scholar 

  • Fujimaki T (2009) Central nervous system germ cell tumors: classification, clinical features, and treatment with a historical overview. J Child Neurol 24:1439–1445

    Article  PubMed  Google Scholar 

  • Fujimaki T, Matsutani M, Funada N, Kirino T, Takakura K, Nakamura O, Tamura A, Sano K (1994) CT and MRI features of intracranial germ cell tumors. J Neurooncol 19:217–226

    Article  PubMed  CAS  Google Scholar 

  • Jennings MT, Gelman R, Hochberg F (1985) Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg 63:155–167

    Article  PubMed  CAS  Google Scholar 

  • Katakami H, Hashida S, Yamaguchi H, Yazawa S, Nakano S, Wakisaka S (2003) Central nervous system germ cell tumor, diagnosis and clinical course: development of ultrasensitive HCG-beta measurement and clinical application. Nippon Naibunpi Gakkai Zasshi 79(Suppl):58–60

    Google Scholar 

  • Kellie SJ, Boyce H, Dunkel IJ, Diez B, Rosenblum M, Brualdi L, Finlay JL (2004) Intensive cisplatin and cyclophosphamide-based chemotherapy without radiotherapy for intracranial germinomas: failure of a primary chemotherapy approach. Pediatr Blood Cancer 43:126–133

    Article  PubMed  Google Scholar 

  • Khatua S, Dhall G, O’Neil S, Jubran R, Villablance JG, Marachelian A, Nastia A, Lavey R, Olch AJ, Gonzalez I, Gilles F, Nelson M, Panigrahy A, McComb G, Krieger M, Fan J, Sposto R, Finlay J (2010) Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation. Pediatr Blood Cancer 55:42–46

    PubMed  Google Scholar 

  • Kochi M, Itoyama Y, Shiraishi S, Kitamura I, Marubayashi T, Ushio Y (2003) Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors. J Neurosurg 99:106–114

    Article  PubMed  Google Scholar 

  • Kretschmar C, Kleinberg L, Greenberg M, Burger P, Holmes E, Wharam M (2007) Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children’s Oncology Group. Pediatr Blood Cancer 48:285–291

    Article  PubMed  CAS  Google Scholar 

  • Luther N, Edgar MA, Dunkel IJ, Souweidane MM (2006) Correlation of endoscopic biopsy with tumor marker status in primary intracranial germ cell tumors. J Neurooncol 79:45–50

    Article  PubMed  Google Scholar 

  • Maity A, Shu HK, Janss A, Belasco JB, Rorke L, Phillips PC, Sutton LN, Goldwein JW (2004) Craniospinal radiation in the treatment of biopsy-proven intracranial germinomas: twenty-five years’ experience in a single center. Int J Radiat Oncol Biol Phys 58:1165–1170

    Article  PubMed  Google Scholar 

  • Matsutani M (2001) Combined chemotherapy and radiation therapy for CNS germ cell tumors – the Japanese experience. J Neurooncol 54:311–316

    Article  PubMed  CAS  Google Scholar 

  • Matsutani M (2010) Long-term follow-up of germinomas treated by ventricular irradiation with 24 Gy and concurrently administered carboplatin and etoposide chemotherapy. Neuro-oncology 12(6):ii28

    Google Scholar 

  • Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N, Seto T (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86:446–455

    Article  PubMed  CAS  Google Scholar 

  • Rosenblum M, Nakazato Y, Matsutani M (2007) CNS germ cell tumors. In: Luis D (ed) WHO classification of tumours of the central nervous system, 4th edn. International Agency for Research on Cancer, Lyon, 197–204

    Google Scholar 

  • Russel DS (1944) The pinealoma: its relationship to teratoma. J Pathol Bacteriol 56:145–150

    Article  Google Scholar 

  • Sano K, Matsutani M, Seto T (1989) So-called intracranial germ cell tumours: personal experiences and a theory of their pathogenesis. Neurol Res 11:118–126

    PubMed  CAS  Google Scholar 

  • Shikama N, Ogawa K, Tanaka S, Toita T, Nakamura K, Uno T, Ohnishi H, Itami J, Tada T, Saeki N (2005) Lack of benefit of spinal irradiation in the primary treatment of intracranial germinoma: a multi-institutional, retrospective review of 180 patients. Cancer 104:126–134

    Article  PubMed  Google Scholar 

  • Silvani A, Eoli M, Salmaggi A, Lamperti E, Fariselli L, Milanesi I, Broggi G, Solero CL, Giombini S, Boiardi A (2005) Combined chemotherapy and radiotherapy for intracranial germinomas in adult patients: a single-institution study. J Neurooncol 71:271–276

    Article  PubMed  CAS  Google Scholar 

  • Sonoda Y, Kumabe T, Sugiyama S, Kanamori M, Yamashita Y, Saito S, Ariga H, Takai Y, Tominaga T (2008) Germ cell tumors in the basal ganglia: problems of early diagnosis and treatment. J Neurosurg Pediatr 2:118–124

    Article  PubMed  Google Scholar 

  • Surawicz TS, McCarthy BJ, Kupelian V, Jukich PJ, Bruner JM, Davis FG (1999) Descriptive epidemiology of primary brain and CNS tumors: results from the Central Brain Tumor Registry of the United States, 1990–1994. Neuro-Oncology 1:14–25

    PubMed  CAS  Google Scholar 

  • The Committee of the Brain Tumor Registry of Japan (2009) Report of Brain Tumor Registry of Japan. Neurol Med Chir (Tokyo) 46(Suppl):5

    Google Scholar 

  • Yoshida J, Sugita K, Kobayashi T, Takakura K, Shitara N, Matsutani M, Tanaka R, Nagai H, Yamada H, Yamashita J (1993) Prognosis of intracranial germ cell tumours: effectiveness of chemotherapy with cisplatin and etoposide (CDDP and VP-16). Acta Neurochir (Wien) 120:111–117

    Article  CAS  Google Scholar 

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  1. Department of Neurosurgery, Saitama Medical University, Moroyama, 350-0495, Japan

    Takamitsu Fujimaki

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Correspondence to Takamitsu Fujimaki .

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  1. , Kean University, Room 213, Library building, Morris Avenue 1000, Union, 07083, New Jersey, USA

    M.A. Hayat

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Fujimaki, T. (2012). Central Nervous System Germ Cell Tumor. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 4. Tumors of the Central Nervous System, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1706-0_7

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  • DOI: https://doi.org/10.1007/978-94-007-1706-0_7

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-1705-3

  • Online ISBN: 978-94-007-1706-0

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