Surgical Debulking Plus Adjuvant Chemoradiotherapy of a Huge Basal Ganglion Nongerminomatous Germ Cell Tumor with Long Term Survival
DOI:
https://doi.org/10.12974/2311-8687.2014.02.02.2Keywords:
Chemoradiotherapy, Germ cell tumor, Nongerminomatous, Survival, Surgery.Abstract
Primary central nerve system germ cell tumors are an uncommon tumor and in most cases occure in the childhood. Histologically, they can be divided to germinomas and nongerminomatous germ cell tumors (NGGCTs). The basal ganglion is an unusual location of NGGCTs and may cause the sign of increased intracranial pressure, mental deterioration, and hemiparesis. The brain MRI is the most preferred diagnostic equipment, and the serum or CSF tumor markers provide more hints to differentiate the subtypes of the NGGCTs preoperatively. Unlike germinomas which are radiation sensitive, the treatment of NGGCTs may need a combined therapy, including surgical debulking, whole brain radiation therapy and systemic chemotherapy. Although the optimal management of intracranial NGGCTs is not established, we provide a case of basal ganglion mixed germ cell tumor (Primary yolk sac tumor with germinoma component) who received near total surgical resection and adjuvant chemoradiotherapy with long term survival. To reach the maximal surgical debulking and avoid the damage of eloquent areas may be the aim of the treatment of NGGCTs for pediatric neurosurgeons and the key to prolonging the patient’s survival.
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