Primary intracranial germ cell tumors in children 36-year experience of a single center

J Cancer Res Ther. 2020 Oct-Dec;16(6):1459-1465. doi: 10.4103/jcrt.JCRT_314_18.

Abstract

Purpose: Intracranial germ cell tumors (ICGCTs) comprise approximately 0.4%-3% of all brain tumors. In this study, we aim to evaluate clinical characteristics, treatment and outcomes of patients with ICGCT.

Patients and methods: All patients with ICGCT diagnosed in Hacettepe University's Pediatric Oncology Department between January 1980 and January 2016 were evaluated, retrospectively.

Results: We identified 52 patients (male/female: 2.46) diagnosed with ICGT. Median age was 140 months. The median duration of symptoms was 3 months. Patients with endocrine symptoms were diagnosed later than others (P = 0.028). The primary site was pineal region in 20 patients, nonpineal region in 32 which included six bifocal involvements. Pineal location was more common in boys than girls (P = 0.02). Histopathological diagnosis was germinoma in 28 patients, nongerminomatous malignant germ cell tumors in 14 and immature teratoma in 4. The mean age for germinoma was higher than that of nongerminomatous tumors (P = 0.032). Patients treated with surgery and radiotherapy and chemotherapy. Median follow-up time was 52.5 months. Thirty-six patients were alive for 12-228 months. Relapsed/progressive disease was observed in 11 patients. Nongerminomatous tumors more frequently showed relapse/progression than germinoma (P = 0.06). Five-year overall and event-free survival rates for the whole group were 72.6% and 57.2%, respectively. Overall and event-free survival rates for germinoma were better than malignant nongerminomatous tumors.

Conclusion: Although the ratio of ICGCTs to central nervous system tumors in our series was similar to western countries, some clinical features such as tumor location were similar to cases from East Asian countries. Although similar protocols were used survival rates lower than developed western and eastern developed countries.

Keywords: Brain tumors; germ cell tumor; germinoma.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Chemoradiotherapy, Adjuvant / methods
  • Chemoradiotherapy, Adjuvant / statistics & numerical data*
  • Child
  • Child, Preschool
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Germinoma / diagnosis
  • Germinoma / mortality
  • Germinoma / pathology
  • Hospitals, Pediatric / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging
  • Male
  • Neoplasm Recurrence, Local / epidemiology*
  • Neurosurgical Procedures / statistics & numerical data*
  • Retrospective Studies
  • Survival Rate
  • Teratoma / diagnosis
  • Teratoma / mortality
  • Teratoma / pathology
  • Teratoma / therapy*
  • Time Factors
  • Tomography, X-Ray Computed
  • Turkey / epidemiology