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Mixed or metachronous germ-cell tumor?

Abstract

Objective and importance

We report the extremely rare occurrence of a second germ-cell tumor at a different site and with different histological types long after total resolution of a pineal germinoma.

Clinical presentation

A 21-year-old man who presented with headache and diplopia was admitted to our hospital. Neuroradiological studies revealed a tumor in the pineal region. The tumor was biopsied with endoscope, and third ventriculostomy was performed. Histologically, the tumor proved to be a germinoma. The patient received 3 cycles of combination chemotherapy consisting of carboplatin and etoposide with radiotherapy. The tumor was totally resolute. Twelve months later, he was readmitted with headache and diplopia. Neuroradiological studies showed a tumor in the right temporal lobe.

Intervention

The second tumor was totally removed. Histologically, the tumor proved to be a mixed germ-cell tumor, which consisted a yolk-sac tumor and a germinoma. After the second course of chemotherapy, magnetic resonance image studies revealed no evidence of the tumor.

Conclusion

The second tumor was considered to be a metachronous neoplasm rather than a recurrence of the original mixed germ-cell tumor, which consisted a yolk-sac tumor and a germinoma.

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Correspondence to Dong-Seok Kim.

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Shim, KW., Kim, DS. & Choi, JU. Mixed or metachronous germ-cell tumor?. Childs Nerv Syst 23, 713–718 (2007). https://doi.org/10.1007/s00381-006-0273-6

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  • DOI: https://doi.org/10.1007/s00381-006-0273-6

Keywords

  • Germ-cell tumor
  • Metachronous
  • Germinoma
  • Mixed germ-cell tumor