Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Diabetes Insipidus , Germinoma/complications , Germinoma/diagnosis , Pituitary NeoplasmsSubject(s)
Adolescent , Humans , Male , Brain Neoplasms/diagnosis , Germinoma/diagnosis , Neuroendoscopy , Pineal Gland , Pinealoma/diagnosisABSTRACT
Objetivos: Evaluación de las características clínicas y los resultados terapéuticos de los tumores germinales malignos (TGM) extra cerebrales tratados según los lineamientos del protocolo TGM 95 de la Sociedad Francesa de Oncología Pediátrica (SFOP) en una sola institución. Pacientes y Métodos: Entre septiembre de 1995 y septiembre de 2005, 110 pacientes (pts) nuevos consecutivos con tumores germinales extra cerebrales fueron registrados en nuestra institución, 62 de los cuales eran malignos, todos ellos fueron evaluados. El primer gesto diagnóstico terapéutico fue la gonadectomía inicial o la detección de niveles elevados de marcadores tumorales. Los pacientes fueron tratados según los lineamientos del Protocolo TGM 95 de la SFOP. Para la enfermedad estadio I-II completamente resecada y con marcadores positivos, se utilizó una estrategia de expectación y seguimiento. Para los casos avanzados de diseminación hemátogena o niveles de alfa fetoproteína superiores a 15.000 ng/ml se empleó el régimen "VIP" (Etopósido, ifosfamida y cisplatino) 4-6 ciclos. El resto de los casos fue tratado con el regimén VBP (vinblastina, bleomicina y cisplatino) 3-5 ciclos. Resultados: La mediana edad para el grupo fue 12.1 (r: 0-17) años. Varones: 30; mujeres:32 (V/M: 0.94). La signo sintomatología clínica varió según la localización y la extensión tumoral. Hubo 13 (21) pacientes en estadio I y 9 (14,5) en estadio II (35,5). En estadio III y 18 (29) en estadío IV. Ocho (12,9) fueron tumores puros del saco vitelino. Cincuenta (80.6) fueron TGM mixtos con variadas combinaciones de componentes malignos teratomatosos. Dos (3,2) fueron teratomas inmaduros de alto grado. Veintiseis (41,9) fueron de origen ovárico, 25 (40,3) testiculares., 6 (9,7) sacrococcigeos, 3 (4,8) mediastinales y 2 (3,2) de otra localización. Catorce pacientes en estadio I-II y enfermedad inicialmente resecada en forma completa, no recibieron quimioterapia luego del a cirugía.
Subject(s)
Child , Adolescent , Germinoma/classification , Germinoma/diagnosis , Germinoma/therapy , Antineoplastic Protocols , Clinical ProtocolsABSTRACT
Synchronous primary intracranial germ cell tumors are rare. Only 5-10% of all germ cell tumors are found as synchronous lesion in pineal and suprasellar region. They are also known by the entity "double mid-line atypical teratoma". An 11-year-old male child presented with polyuria, polydipsia and features of raised intracranial tension. CT scan head revealed well-defined homogenously enhancing lesions in the pineal and suprasellar region. Histopathology examination showed the lesion to be of germ cell origin.
Subject(s)
Brain Neoplasms/diagnosis , Bromhexine , Child , Germinoma/diagnosis , Humans , Male , Neoplasms, Multiple Primary/diagnosis , Pineal Gland , Pinealoma/diagnosisABSTRACT
A case of pineal germinaoma spreading along the basal subarachnoid space, clinically and macroscopically at autopsy, resembling tuberculous basal arachnoiditis is reported. Need to carry out CSF cytology of even hemorrhagic CSF is stressed, to diagnose the condition.
Subject(s)
Adult , Brain Neoplasms/diagnosis , Diagnosis, Differential , Female , Germinoma/diagnosis , Humans , Neoplasm Invasiveness , Pineal Gland , Subarachnoid Space/pathology , Tuberculosis, Meningeal/diagnosisABSTRACT
Germs cell tumors of extrapineal region are extremely uncommon. The clinicopathological features of germinoma in the basal ganglia, in a 21 year old male are presented in this report. Post-operative radiotherapy is advocated, in view of the good radiosensitivity of these tumors.
Subject(s)
Adult , Basal Ganglia Diseases/diagnosis , Combined Modality Therapy , Craniotomy , Germinoma/diagnosis , Humans , MaleABSTRACT
BACKGROUND: The prognosis of patients with germ cell tumours of the testis has Improved over the past two decades following cisplatinum-based chemotherapy. Currently, staging and risk assessment of the disease is crucial in order to provide curative therapy for patients with poor risk features and not over-treat good risk patients. METHODS: We reviewed the case records of 71 men diagnosed to have germ cell tumours between January 1993 and October 1999. Their clinical characteristics, staging, treatment outcome and prognostic factors for response and survival were analysed. RESULTS: The median age of the patients was 30 years (range: 3-65 years); 69% were in the third and fourth decades. Sixty-one patients (86%) had a primary testicular tumour while in 10 (14%) the tumour was extragonadal. Histopathologically, 53 patients (75%) had non-seminomatous germ cell tumours and 15 (21%) had a seminoma. Twenty-seven patients (62%) had evidence of metastatic disease at the time of diagnosis. On prognostication, non-seminomatous germ cell tumour patients could be divded into good, intemediate and poor prognostic groups comprising 41%, 17% and 40% of patients, respectively. All patients with a seminoma were in the good prognostic subgroup. Fifty-eight patients were evaluable for response. Overall, 91% of patients responded: complete response 71% and partial response 20%. Complete response rates were signiflcantly higher for the good risk (95%) compared to the intermediate (49%) and poor risk (47%) categories (p< 0.003). At a median follow up of 26 months, the 2-year overall and progression-free survival for all patients was 70% and 57%, respectively. The predictors for decreased overall and progression-free survival were age >35 years, presence of poor risk features and mediastinal primary disease. CONCLUSION: The outcome for germ cell tumours in men with good risk is excellent. A protocol consisting of bleomycin, etoposide and cisplatin is effective. Tailoring of chemotherapy In good risk patients to minimize toxicity and Improving results in poor risk patients are areas that need further work.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Germinoma/diagnosis , Humans , Infant , Male , Middle Aged , Prognosis , Retrospective Studies , Testicular Neoplasms/diagnosisSubject(s)
Germinoma/diagnosis , Health Services Accessibility , Humans , Male , Prognosis , Testicular Neoplasms/diagnosisABSTRACT
Os processos expansivos situados ao nível da região selar constituem um variável número de patologias que, apesar da localização semelhante, têm características clínicas, radiológicas, patológicas e origens diferentes. Assim sendo, diferentes tipos de abordagens são utilizados no tratamento cirúrgico destas lesões. Dentre os acessos transcranianos convencionais e os mais sofisticados acessos à base do crânio, o acesso sub-frontal proporciona visão direta das estruturas neurovasculares da região. Este estudo descreve 19 tumores operados por esta via, no período compreendido de fevereiro de 1997 a março de 1998. Onze destas lesões eram adenomas pituitários, 3 eram craniofaringiomas, 2 eram meningiomas, 1 germinoma e 1 lesão inflamatória do nervo óptico. A remoção total dos tumores foi conseguida em 17 casos. Não houve mortalidade operatória e as complicações mais comuns foram: anosmia unilateral, que ocorreu em 12 casos; diabetes insipidus transitório, que acometeu 4 pacientes; e déficit isquêmico progressivo, que ocorreu em 1 paciente. Estes resultados demonstram que a via sub-frontal é uma opção segura para a cirurgia dos tumores desta região.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Adenoma/surgery , Central Nervous System Neoplasms/surgery , Craniopharyngioma/surgery , Germinoma/surgery , Optic Neuritis/surgery , Sella Turcica/surgery , Germinoma/diagnosis , Hypothalamic Neoplasms/diagnosis , Magnetic Resonance Imaging , Meningeal Neoplasms/diagnosis , Meningioma/diagnosis , Postoperative ComplicationsABSTRACT
Testicular germ cell tumor [TGCT] is the most solid tumor in 20 - 40 years old man. TGCT account for 95% of testicular tumors and represent a unique type of human cancer from several different perspectives. TGCT arise by transformation of germ cells. The Transformed germ cells exhibit ploripotentially to differentiate into embryonic. Extra-embryonic, and somatic tissue types, and are highly sensitive to cisplatin-based chemotherapy. Investigation into the genetics of TGCT can provide methods of molecular diagnosis and help to the understanding of molecular basis of transformation, differentiation and sensitivity/resistance. The molecular basis for the chemosensitivity of these tumors is poorly understood, although initial studies suggest that wild-type p53 might play a central role, further studies will provide insights into why other solid tumors remain far from curable. The following review will provide information about genetic altration and chromosomal aberration occur in TGCT. These studies have identified multiplication of 12p, manifested in I [12p] or tandem duplication of 12p. As a unique change in TGCT which serves as a diagnostic marker. These data also indicate that multiple genetic events play a role in distinct pathways in the development of TGCT, and further elucidation of the underlying genetic and biochemical mechanisms is central to unraveling biology and improving treatment of TGCT
Subject(s)
Humans , Male , Germinoma/diagnosis , Germinoma/drug therapy , Tumor Suppressor Protein p53 , Chromosome AberrationsABSTRACT
Descrevemos o caso de um paciente com diagnóstico de germinoma nos núcleos da base e tálamo, com invasao do tronco cerebral, ressaltando as características observadas nos exames de tomografia computadorizada e de ressonância magnética, os possíveis diagnósticos diferenciais, e a necessidade da comprovaçao anátomo-patológica, por tratar-se de localizaçao pouco frequente de um tumor com possibilidade de evoluçao favorável após tratamento com quimio e radioterapia.
Subject(s)
Adult , Humans , Male , Basal Ganglia , Brain Neoplasms/diagnosis , Brain Stem , Germinoma/diagnosis , Thalamus , Brain Neoplasms/pathology , Diagnosis, Differential , Germinoma/pathology , Magnetic Resonance Spectroscopy , Tomography, X-Ray ComputedSubject(s)
Humans , Male , Germinoma/pathology , Germinoma/diagnosis , Staining and Labeling/methodsSubject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Germinoma/diagnosis , Biomarkers, Tumor , Germinoma/therapy , Neoplasm Staging , Diagnosis, DifferentialABSTRACT
A case of advanced germ cell tumour of ovary [dysgerminoma] in pregnancy is being described. The entity is usually difficult to diagnose. Utilizing conservative surgical procedures in young females in the early stages of the disease, fertility can be conserved
Subject(s)
Germinoma/diagnosis , Pregnancy Complications, Neoplastic , Laparotomy/methodsABSTRACT
Persistent mullerian duct syndrome [PMDS] is a rare disorder of sexual development, it is characteristically associated with undescended tests testicular tumours are not uncommon in this group of patients. We report a case of PMDS with mixed germ cell tumour in the left undescended testis
Subject(s)
Germinoma/diagnosis , Cryptorchidism/pathology , Syndrome , TestisABSTRACT
Se analiza el caso infrecuente de un paciente masculino de 25 años con germinoma primario de mediastino que cursó concomitantemente con un cuadro de Hipertensión Arterial secundaria de 5 años de evolución refractaria a tratamiento farmacológico (propanolol). Posterior a radioterapia se normalizaron las cifras tensionales. Se revisó la literatura mundial, encontrándose un caso de teratocarcinoma con un comportamiento similar al nuestro. El germinoma primario de mediastino es una entidad reconocida ampliamente, con diversas publicaciones al respecto. Se ha tratado de explicar su origen a través de células germinales desplazadas.
Subject(s)
Adult , Humans , Male , Germinoma/diagnosis , Hypertension , MediastinumABSTRACT
Os autores apresentam um caso de germinoma da glândula pineal tratado por remoçao cirúrgica e radioterapia. Os tumores da pineal ocupam um segmento relativamente pequeno, aproximadamente 0,5 por cento dos tumores intracranianos. Sao discutidas as características clínicas, patológicas e cirúrgicas e tratamento complementar com radioterapia.
Subject(s)
Humans , Male , Adolescent , Brain Neoplasms , Germinoma , Pineal Gland , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Brain Neoplasms/therapy , Germinoma/diagnosis , Germinoma/pathology , Germinoma/therapy , Pineal Gland/pathology , Tomography, X-Ray ComputedABSTRACT
A single case report of a patient with primary extragonadal endodermal sinus tumor affecting the maxillary region is reported here. The patient was treated with combination chemotherapy consisting of bleomycin, cisplatin and etoposide. The child achieved complete remission and is now disease free for three years.