Turkish Neurosurgery
Primary Intracranial Germinomas: Retrospective Analysis of Five Consecutively Operated Cases
Anas Abdallah1, Murad Asiltürk1, Mustafa Levent Uysal1, Erhan Emel1, Betül Güler Abdallah1, Bilge Bilgiç2, Gökçen Gündoğdu2
1Bakirkoy Research and Training Hospital for Neurology Neurosurgery and Psychiatry, Department of Neurosurgery, Bakırköy,
2Istanbul University Faculty of Medicine, Department of Pathology, Fatih,
DOI: 10.5137/1019-5149.JTN.17474-16.3

Aim:Primary intracranial germinomas (PIGs) are rare malignant brain tumors that represent approximately 0.2% to 1.7% of all primary intracranial tumors. PIGs have infrequent, but existent possibility of spinal cord metastases. In this study, clinical outcomes of five consecutive PIGs have been presented.Material and Methods:Medical records were retrospectively reviewed in 1,849 cases of intracranial tumors whom underwent surgery between the years 2005 and 2015, cases which confirmed as germinoma histopathologically were included in this study. Results:Five cases of PIGs were detected in two girl (40%) and 3 male (60%) patients. The mean age was 15.2±5.6 (8-23) years. The mean follow-up period was 52.3±56.4 (9-135) months. The most common complaint was headache (60%), which followed by nausea±vomiting (40%). Four cases (80%) were affected suprasellar region while the fifth patient’s tumor was localized in pineal region. The duration between the initial symptom and time of surgical intervention ranged between 15 days and 2 months. After 12 months of the first operation, one patient was presented with drop seeding metastasis. 4-year survival (with exception of the case which died as a early surgical complication) was 100%. Gross-total resection was achieved in one patient. Surgical mortality rate was 20%. PIGs’ morbidity rate was 60%. Conclusion:PIG is mostly malignant tumor that generally affects pediatric age group. They are radiosensitive tumors, therefore, subtotal or near-total using stereotactic guide or direct surgery to confirm the histopathological diagnosis followed by chemotherapy and whole brain or in some cases craniospinal radiotherapy rather than GTR is the treatment of choice.

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