Intramedullary recurrence of germinoma in the spinal cord 15 years after complete remission of a pineal lesion Case report

被引:10
作者
Hanakita, Shunya [1 ]
Takenobu, Atumi [2 ]
Kambe, Atsushi [3 ]
Watanabe, Takashi [3 ]
Shin, Masahiro
Teraoka, Akira [2 ]
机构
[1] Tokyo Univ Hosp, Dept Neurosurg, Bunkyo Ku, Tokyo 1138655, Japan
[2] Teraoka Mem Hosp, Dept Neurosurg, Fukuyama, Hiroshima, Japan
[3] Univ Tottori Hosp, Dept Neurosurg, Yonago, Tottori, Japan
关键词
complete remission; germinoma; oncology; intramedullary recurrence; GERM-CELL TUMORS; CENTRAL-NERVOUS-SYSTEM; PHASE-II TRIAL; INTRACRANIAL GERMINOMA; RADIATION-THERAPY; IRRADIATION; CHEMOTHERAPY; RADIOTHERAPY; METASTASIS; EXPERIENCE;
D O I
10.3171/2012.2.SPINE11499
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The authors present a case of germinoma that was initially found in the pineal region and recurred 15 years later in the intramedullary cervical spinal cord after intensive chemo- and radiotherapy and diagnosis of complete remission. This 28-year-old man initially presented with seizures. Hydrocephalus and a pineal tumor were found on radiological examination, and partial resection of the tumor was performed. Histological diagnosis showed a pure germinoma. Following surgery, the patient received a combination of chemo- and radiotherapy, and a complete remission was shown. However, after 15 years of follow-up, he presented with gait disturbances. Spinal MRI showed an intramedullary mass lesion in the cervical spinal cord. The cervical lesion was biopsied, and histological examination again revealed a pure germinoma. With germinomas, the possibility of a drop metastasis from an intracranial lesion to the spinal cord must be considered during follow-up. However, in the present case, analysis of a CSF sample showed no abnormalities as in previously published cases. In recent years, multidisciplinary treatments have demonstrated good event-free survival rates in cases of pure germinomas, but long-term outcomes over the decades are not fully known. Continual follow-up of such cases is recommended even after complete remission has been achieved. (http://thejns.org/doi/abs/10.3171/2012.2.SPINE11499)
引用
收藏
页码:513 / 515
页数:3
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