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Staged operations for a hypervascular mixed germ cell tumor with growing teratoma syndrome: a case report

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Abstract

Introduction

A mixed germ cell tumor with a teratoma component can become enlarged following chemotherapy, and such an event is diagnosed as growing teratoma syndrome. Removing large, hypervascular tumors including a tumor encased by developed vasculatures from the pineal region is challenging during a single operation.

Case report

A 15-year-old male underwent chemotherapy for mixed germ cell tumors according to the KSPNO G082 protocol. This case of a mixed germ cell tumor with growing teratoma syndrome was recognized very early during chemotherapy. The tumor was completely removed during the staged operations. First, the anteriorly located tumor on the third ventricle was removed via the transcallosal interforniceal approach, and 1 month later, the occipital transtentorial approach was used for the pineal tumor with decreased vascularity.

Conclusion

Performing staged operations could be recommended for large hypervascular pineal tumors, which can be safely removed during the second operation once vascularity has decreased.

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References

  1. Bowzyk Al-Naeeb A, Murray M, Horan G, Harris F, Kortmann RD, Nicholson J (2018) Current management of intracranial germ cell tumours. Clin Oncol (R Coll Radiol) 30(4):204–214

    Article  CAS  Google Scholar 

  2. Makino K, Nakamura H, Yano S, Kuratsu J, Kumamoto Brain Tumor Research G (2013) Incidence of primary central nervous system germ cell tumors in childhood: a regional survey in Kumamoto prefecture in southern Japan. Pediatr Neurosurg 49(3):155–158

    Article  Google Scholar 

  3. Sato K, Takeuchi H, Kubota T (2009) Pathology of intracranial germ cell tumors. Prog Neurol Surg 23:59–75

    Article  Google Scholar 

  4. Kim CY, Choi JW, Lee JY, Kim SK, Wang KC, Park SH (2011) Intracranial growing teratoma syndrome: clinical characteristics and treatment strategy. J Neurooncol 101(1):109–115

    Article  Google Scholar 

  5. Azab WA, Nasim K, Salaheddin W (2014) An overview of the current surgical options for pineal region tumors. Surg Neurol Int 5:39

    Article  Google Scholar 

  6. Little KM, Friedman AH, Fukushima T (2001) Surgical approaches to pineal region tumors. J Neurooncol 54(3):287–299

    Article  CAS  Google Scholar 

  7. Sonabend AM, Bowden S, Bruce JN (2016) Microsurgical resection of pineal region tumors. J Neurooncol 130(2):351–366

    Article  CAS  Google Scholar 

  8. Raslan AM, Liu JK, McMenomey SO, Delashaw JB Jr (2012) Staged resection of large vestibular schwannomas. J Neurosurg 116(5):1126–1133

    Article  Google Scholar 

  9. Han JW, Koh KN, Kim JY, Baek HJ, Lee JW, Shim KW (2016) Current trends in management for central nervous system germ cell tumor. Clin Pediatr Hematol Oncol 23:17–27

    Article  Google Scholar 

  10. Jia W, Ma Z, Liu IY, Zhang Y, Jia G, Wan W (2011) Transcallosal interforniceal approach to pineal region tumors in 150 children. J Neurosurg Pediatr 7(1):98–103

    Article  Google Scholar 

  11. Logothetis CJ, Samuels ML, Trindade A, Johnson DE (1982) The growing teratoma syndrome. Cancer 50(8):1629–1635

    Article  CAS  Google Scholar 

  12. Michaiel G, Strother D, Gottardo N, Bartels U, Coltin H, Hukin J (2020) Intracranial growing teratoma syndrome (iGTS): an international case series and review of the literature. J Neurooncol 147(3):721–730

    Article  CAS  Google Scholar 

  13. Nakamura T, Fukuoka K, Ikeda J, Yoshitomi M, Udaka N, Tanoshima R (2017) Encouraging option of multi-staged gross total resection for a C11orf-RelA fusion-positive supratentorial anaplastic ependymoma. Brain Tumor Pathol 34(4):160–164

    Article  CAS  Google Scholar 

  14. Todeschini AB, Shahein M, Montaser AS, Hardesty D, Otto BA, Carrau RL (2019) Giant olfactory groove meningioma-2-staged approach: 2-dimensional operative video. Oper Neurosurg (Hagerstown) 6(1):115–116

    Article  Google Scholar 

Download references

Funding

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT, and Future Planning (2020R1I1A3073338).

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Authors and Affiliations

  1. Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Chonnam, Republic of Korea

    Tae-Young Jung

  2. Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Chonnam, Republic of Korea

    Hee-Jo Baek

  3. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital and Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea

    Seul-Kee Kim

  4. Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Chonnam, Republic of Korea

    Kyung-Hwa Lee

Authors
  1. Tae-Young Jung
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  2. Hee-Jo Baek
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  3. Seul-Kee Kim
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  4. Kyung-Hwa Lee
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Corresponding author

Correspondence to Tae-Young Jung.

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Ethics approval

This study complies with the World Medical Association Declaration of Helsinki, and this retrospective study was approved by the institutional review board of Chonnam National Univeristy Hwasun Hospital (CNUHH-2020–103). Written informed consent was obtained from the patient’s parents for publication of this case report and any accompanying images.

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The authors declare no competing interests.

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Jung, TY., Baek, HJ., Kim, SK. et al. Staged operations for a hypervascular mixed germ cell tumor with growing teratoma syndrome: a case report. Childs Nerv Syst 38, 11–16 (2022). https://doi.org/10.1007/s00381-021-05393-4

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  • DOI: https://doi.org/10.1007/s00381-021-05393-4

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