Acta clinica Croatica, Vol. 62. No. 1, 2023.
Book review
https://doi.org/10.20471/acc.2023.62.01.28
Rare Intracranial Multifocal Non-Germinomatous Germ Cell Tumor in an 18-Year-Old Male: A Case Report
Nikolina Sesar
; Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Bruno Splavski
; Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Josip Juraj Strossmayer University Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University Faculty of Dental Medicine and Health, Osijek, Croatia
Marija Gamulin
; Department of Oncology, Zagreb University Hospital Center, Zagreb, Croatia University of Zagreb School of Medicine, Zagreb, Croatia; Referral Center for the Treatment of Germ Cell Tumors and Extragonadal Germ Cell Tumors in Republic of Croatia, Zagreb, Croatia
Krešimir Rotim
; Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Josip Juraj Strossmayer University Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Abstract
Intracranial germ cell tumors are rare brain tumors that are distinguished based on
their histology and selected tumor markers. Non-germinomatous germ cell tumors are a diverse group
of such tumors having the poorest prognosis. Most commonly, they are located in the suprasellar and
pineal regions. Since the exact treatment protocol has not yet been established, there is currently no
standardized modality of management. We present a case of intracranial multifocal non-germinomatous
germ cell tumor in an 18-year-old male, along with relevant literature review. We describe
initial diagnostic and treatment procedures in a young adult presented with diplopia and ataxic gait.
Neuroradiological findings and elevated alpha fetoprotein and beta chain of the human chorionic gonadotropin
tumor markers indicated the possible mixed germ cell tumor. Chemotherapy regimen was
adjusted accordingly, biopsy was not performed. The patient’s clinical condition improved significantly
and his alpha fetoprotein values decreased remarkably after initiation of chemotherapy. In conclusion,
initial evaluation with neuroimaging, tumor markers, and cytology from cerebrospinal fluid is important
as guidance to further treatment and prognosis. In selected cases, biopsy may not be indicated to
start adjuvant chemotherapy. We emphasize the importance of specific treatment modality selection
based mainly on tumor markers, regardless of the precise histologic classification.
Keywords
Non-germinomatous germ cell tumor, intracranial; Alpha fetoprotein; Beta human chorionic gonadotropin; Biopsy; Chemotherapy
Hrčak ID:
307319
URI
Publication date:
1.4.2023.
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