Abstract
Background
Patients with neurohypophyseal germ cell tumors (GCTs) typically present with visual problems. Hence, this study aimed to assess optic pathway involvement based on clinical and radiological findings and to validate the outcome of visual function.
Methods
A total of 16 patients with newly diagnosed neurohypophyseal GCTs who were treated at the University of Tsukuba Hospital between 2000 and 2020 were included in this study.
Results
The median interval from symptom onset to diagnosis was 173.5 days (range, 33–1588 days). Patients with visual disturbance at diagnosis had a longer time to diagnosis compared with those without. Ophthalmologic abnormalities were frequently observed, with an incidence rate of 69%. Fifty percent of patients exhibited optic pathway involvement detected via magnetic resonance imaging (MRI). Visual impairment was more severe in the patients with optic pathway involvement (p = 0.002). Post-treatment visual impairment was improved but was still significantly severe in patients with optic pathway involvement than in those without involvement (p = 0.010). Visual field deficit more likely remained with an improvement rate of 50%, whereas the improvement rate of visual acuity was 78%. Further, none developed late-onset visual deterioration during the follow-up period.
Conclusions
Visual disturbance and optic pathway involvement are common in neurohypophyseal GCTs. Visual impairment particularly in patients with optic pathway involvement on MRI is more likely to remain at follow-up, although the outcome of visual function is acceptable in most cases.
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Data availability
Deidentified raw data is available upon request.
Code availability
Available upon request.
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All authors contributed to the study conception and design. Material preparation and data collection were performed by Ai Muroi, Takao Tsurubuchi, Tomokazu Sekine, Hiroko Fukushima, Ryoko Suzuki, Yuni Yamaki, Masahide Matsuda, and Hiroyoshi Akutsu. The first draft of the manuscript was written by Ai Muroi, and all the authors commented on previous versions of the manuscript. Shingo Takano and Eiichi Ishikawa critically supervised the manuscript. All authors read and approved the final manuscript.
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This study was performed in accordance with the principles of the Declaration of Helsinki, and it was approved by the ethics committee of the University of Tsukuba Hospital (R02-202).
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In accordance with the ethical standards of our institutional review board, a written informed consent was not required for retrospective analyses because this observational study did not modify existing diagnostic or therapeutic strategies. However, consent was obtained in the opt-out form on the website.
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Muroi, A., Takano, S., Tsurubuchi, T. et al. Involvement of the optic pathway and outcome of visual function in patients with neurohypophyseal germ cell tumor. Acta Neurochir 163, 3191–3199 (2021). https://doi.org/10.1007/s00701-021-04946-5
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DOI: https://doi.org/10.1007/s00701-021-04946-5