Summary
Objective. Pure pineal germinomas have been rarely reported in girls. Gender incidence and differences of pure pineal germinomas are not well known. The authors report a series of pure pineal germinoma and its gender characteristic is reviewed.
Methods and Results. Of a total of 50 germ cell tumors operated on between 1988 and 2004 we found 26 cases (median age at diagnosis, 12 years) of pineal germ cell tumors. Of these, 14 cases (male/female ratio: 13/1) were pure pineal germinomas, and 12 cases (male/female ratio: 12/0) were non-germinoma germ cell tumors. In pure pineal germinomas, the main clinical presentations were intracranial hypertension and cranial nerve dysfunction. Imaging studies disclosed a homogeneous type of tumor (n = 10) and associated hydrocephalus (n = 6). Cases were managed with biopsy and subsequent radiation therapy and chemotherapy. After a follow up of 10 years, pure germinoma cases have no neurological deficits and tumor recurrence. The literature on gender incidence of pure pineal germinomas is analyzed and possible causes are discussed.
Conclusions. Although rare, pure pineal germinoma can be found in female subjects. On the basis of the literature review, the male/female ratio in cases of pure pineal germinoma is between 5:1 and 22:1 (mean 14:1). In our series, the male/female ratio was 13:1.
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References
E Abay E Laws G Grado J Bruckman G Forbes M Gomez M Scott (1981) ArticleTitlePineal tumors in children and adolescents: treatment by CSF shunting and radiotherapy J Neurosurg 55 889–891 Occurrence Handle7299463
P Agranat P Jedynak B Epardeau JM Extra L Mignot (1995) ArticleTitleCerebral germ cell tumors in adults. A retrospective study of 19 cases Bull Cancer 82 650–659 Occurrence Handle7492821 Occurrence Handle1:STN:280:DyaK28%2Fps1GqsQ%3D%3D
J Allen J Kim R Packer (1987) ArticleTitleNeoadjuvant chemotherapy for newly diagnosed germ cell tumor of the central nervous system J Neurosurg 67 65–69 Occurrence Handle2439668 Occurrence Handle1:STN:280:DyaL2s3ltlemuw%3D%3D
M Bamberg KR Kortmann G Calaminus G Becker G Meisner D Harms U Göbel (1999) ArticleTitleRadiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89 J Clin Oncol 17 2585–2592 Occurrence Handle10561326 Occurrence Handle1:STN:280:DC%2BD3c%2FjtVSmtw%3D%3D
J Bjornsson BW Scheithauer H Okazaki RW Leech (1985) ArticleTitleIntracranial germ cell tumors: pathobiological and immunohistochemical aspects of 70 cases J Neuropathol Exp Neurol 44 32–46 Occurrence Handle4038412 Occurrence Handle1:STN:280:DyaL2M%2Fot1WnsQ%3D%3D
JN Bruce BM Stein (1990) ArticleTitlePineal tumors Neurosurg Clin North Am 1 123–138 Occurrence Handle1:STN:280:DyaK38zitlamsw%3D%3D
JM Buatti WA Friedman (2002) ArticleTitleTemporary ventricular drainage and emergency radiotherapy in the management of hydrocephalus associated with germinoma J Neurosurg 96 1020–1022 Occurrence Handle12066901 Occurrence Handle10.3171/jns.2002.96.6.1020
G Calaminus M Bamberg MC Baranzelli Y Benoit LC di Montezemolo F Fossati-Bellani H Jurgens HJ Kuhl HG Lenard ML Curto (1994) ArticleTitleIntracranial germ cell tumors: a comprehensive update of the European data Neuropediatrics 25 26–32 Occurrence Handle8208347 Occurrence Handle1:STN:280:DyaK2c3mvVKhtg%3D%3D
L Casentini F Colombo F Pozza A Benedetti (1990) ArticleTitleCombined radiosurgery and external radiotherapy of intracranial germinomas Surg Neurol 34 79–86 Occurrence Handle2195685 Occurrence Handle1:STN:280:DyaK3czht1ehsA%3D%3D Occurrence Handle10.1016/0090-3019(90)90101-T
MK Cheng (1982) ArticleTitleBrain tumors in the People’s Republic of China: a statistical review Neurosurgery 10 16–21 Occurrence Handle7057973 Occurrence Handle1:STN:280:DyaL387isFOlsg%3D%3D Occurrence Handle10.1227/00006123-198201000-00003
BK Cho KC Wang DH Nam DG Kim HW Jung HJ Kim DH Han KS Choi (1998) ArticleTitlePineal tumors: experience with 48 cases over 10 years Childs Nerv Syst 14 53–58 Occurrence Handle9548342 Occurrence Handle1:STN:280:DyaK1c3gvVWiuw%3D%3D Occurrence Handle10.1007/s003810050175
JU Choi DS Kim SS Chung TS Kim (1998) ArticleTitleTreatment of germ cell tumors in the pineal region Childs Nerv Syst 14 41–48 Occurrence Handle9548340 Occurrence Handle1:STN:280:DyaK1c3gvVWitQ%3D%3D Occurrence Handle10.1007/s003810050173
DP Dearnaley RP A’Hern S Whittaker HJ Bloom (1990) ArticleTitlePineal and CNS germ cell tumors: Royal Marsden hospital experience 1962–1987 Int J Radiat Oncol Biol Phys 18 773–781 Occurrence Handle2323968 Occurrence Handle1:STN:280:DyaK3c3hs1ensw%3D%3D
JF Donat H Okazaki MR Gomez TJ Reagan HL Baker ER Laws SuffixJr (1978) ArticleTitlePineal tumors: a 53-year experience Arch Neurol 35 736–740 Occurrence Handle718471 Occurrence Handle1:STN:280:DyaE1M%2FmtFCquw%3D%3D
MS Edwards RJ Hudgins CB Wilson VA Levin WM Wara (1988) ArticleTitlePineal region tumors in children J Neurosurg 68 689–697 Occurrence Handle2451717 Occurrence Handle1:STN:280:DyaL1c7oslOqtA%3D%3D
A Franzini F Leocata D Servello L Cajola A Allegranza G Broggi (1998) ArticleTitleLong-term follow-up of germinoma after stereotactic biopsy and brain radiotherapy: a cell kinetics study J Neurol 245 593–597 Occurrence Handle9758297 Occurrence Handle1:STN:280:DyaK1cvivFaltg%3D%3D Occurrence Handle10.1007/s004150050251
M Fukui Y Natori T Matsushima S Nishio K Ikezaki (1998) ArticleTitleOperative approaches to the pineal region tumors Childs Nerv Syst 14 49–52 Occurrence Handle9548341 Occurrence Handle1:STN:280:DyaK1c3gvVWiug%3D%3D Occurrence Handle10.1007/s003810050174
BG Fuller DS Kapp R Cox (1994) ArticleTitleRadiation therapy of pineal region tumors: 25 new cases and a review of 208 previously reported cases Int J Radiat Oncol Biol Phys 28 229–245 Occurrence Handle8270446 Occurrence Handle1:STN:280:DyaK2c%2FpsFCmsw%3D%3D
MR Gaab HWS Schroeder (1998) ArticleTitleNeuroendoscopic approach to intraventricular lesions J Neurosurg 88 496–505 Occurrence Handle9488304 Occurrence Handle1:STN:280:DyaK1c7kslKhug%3D%3D
C Glanzmann W Seelentag (1989) ArticleTitleRadiotherapy for tumors of the pineal region and suprasellar germinomas Radiother Oncol 16 31–40 Occurrence Handle2813835 Occurrence Handle1:STN:280:DyaK3c%2Fkslyjuw%3D%3D Occurrence Handle10.1016/0167-8140(89)90068-6
HD Herrmann D Winkler M Westphal (1992) ArticleTitleTreatment of tumors of the pineal region and posterior part of the third ventricle Acta Neurochir (Wien) 116 137–146 Occurrence Handle1:STN:280:DyaK38zmslGrsQ%3D%3D Occurrence Handle10.1007/BF01540866
PW Hitchon MM Abu-Yousef CJ Graf DM Turner JC Van Gilder (1983) ArticleTitleManagement and outcome of pineal region tumors Neurosurgery 13 248–253 Occurrence Handle6621838 Occurrence Handle1:STN:280:DyaL2c%2FhsVCjug%3D%3D
DM Ho HC Liu (1992) ArticleTitlePrimary intracranial germ cell tumor. Pathologic study of 51 patients Cancer 70 1577–1584 Occurrence Handle1325276 Occurrence Handle1:STN:280:DyaK38zos1ChtA%3D%3D Occurrence Handle10.1002/1097-0142(19920915)70:6<1577::AID-CNCR2820700622>3.0.CO;2-X
HJ Hoffman H Otsubo EB Hendrick RP Humphreys JM Drake LE Becker M Greenberg D Jenkin (1991) ArticleTitleIntracranial germ-cell tumors in children J Neurosurg 74 545–551 Occurrence Handle1848284 Occurrence Handle1:STN:280:DyaK3M7mt1egsw%3D%3D
HJ Hoffman M Yoshida LE Becker EB Hendrick RP Humphreys (1994) ArticleTitlePineal region tumors in childhood. Experience at the hospital for sick children. 1983 Pediatr Neurosurg 21 91–103 Occurrence Handle7947318 Occurrence Handle1:STN:280:DyaK2M%2FjsVejsQ%3D%3D Occurrence Handle10.1159/000120821
MB Horowitz WA Hall (1991) ArticleTitleCentral nervous system germinomas. A review Arch Neurol 48 652–657 Occurrence Handle2039390 Occurrence Handle1:STN:280:DyaK3M3kvVShtA%3D%3D
RD Jenkin WJ Simpson CW Keen (1978) ArticleTitlePineal and suprasellar germinomas. Results of radiation treatment J Neurosurg 48 99–107 Occurrence Handle619029 Occurrence Handle1:STN:280:DyaE1c%2FmvValtg%3D%3D
D Jenkin M Berry H Chan M Greenberg B Hendrick H Hoffman R Humphreys M Sonley S Weitzman (1990) ArticleTitlePineal region germinomas in childhood treatment considerations Int J Radiat Oncol Biol Phys 18 541–545 Occurrence Handle2318686 Occurrence Handle1:STN:280:DyaK3c3gt1CnsA%3D%3D
MT Jennings R Gelman F Hochberg (1985) ArticleTitleIntracranial germ-cell tumors. Natural history and pathogenesis J Neurosurg 63 155–167 Occurrence Handle2991485 Occurrence Handle1:STN:280:DyaL2M3mtlyhsQ%3D%3D
R Jooma BE Kendall (1983) ArticleTitleDiagnosis and management of pineal tumors J Neurosurg 58 654–665 Occurrence Handle6834112 Occurrence Handle1:STN:280:DyaL3s7mtlelug%3D%3D
R Kalff HE Clar M Bamberg J Holldack (1985) ArticleTitleTumors of the pineal region in children and adolescents Acta Neurochir [Suppl] 35 119–122 Occurrence Handle1:STN:280:DyaL287is1eitA%3D%3D
JI Kuratsu Y Ushio (1996) ArticleTitleEpidemiological study of primary intracranial tumors: a regional survey in Kumamoto Prefecture in the southern part of Japan J Neurosurg 84 946–950 Occurrence Handle8847588 Occurrence Handle1:STN:280:DyaK283jslygtA%3D%3D Occurrence Handle10.3171/jns.1996.84.6.0946
C Lapras J Patet (1987) Controversies, techniques, and strategies for pineal tumor surgery M Apuzzo (Eds) Surgery of the third ventricle Williams & Wilkins Baltimore 649–683
L Manera J Regis O Chinot D Porcheron O Levrier P Farnarier JC Peragut (1996) ArticleTitlePineal region tumors: the role of stereotactic radiosurgery Stereotact Funct Neurosurg 66 164–173 Occurrence Handle9032858
N Matsumura M Kurimoto S Endo O Fukuda A Takaku (1998) ArticleTitleIntracranial germinoma associated with Down’s syndrome. Report of 2 cases Pediatr Neurosurg 29 199–202 Occurrence Handle9876249 Occurrence Handle1:STN:280:DyaK1M%2FpsVyntw%3D%3D Occurrence Handle10.1159/000028721
M Matsutani K Sano K Takakura T Fujimaki O Nakamura N Funata T Seto (1997) ArticleTitlePrimary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases J Neurosurg 86 446–455 Occurrence Handle9046301 Occurrence Handle1:STN:280:DyaK2s7pvVantQ%3D%3D Occurrence Handle10.3171/jns.1997.86.3.0446
W Marsh E Laws (1984) ArticleTitleShunting and irradiation of pineal tumors Clin Neurosurg 32 384–388
TE Merchant SH Sherwood RK Mulhern SR Rose SJ Thompson RA Sanford LE Kun (2000) ArticleTitleCNS germinoma: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation Int J Radiat Oncol Biol Phys 46 1171–1176 Occurrence Handle10725628 Occurrence Handle1:STN:280:DC%2BD3c7ptFOltw%3D%3D Occurrence Handle10.1016/S0360-3016(99)00375-2
KW Min BW Scheithauer (1990) ArticleTitlePineal germinomas and testicular seminoma: a comparative ultrastructural study with special references to early carcinomatous transformation Ultrastruct Pathol 14 483–496 Occurrence Handle2281547 Occurrence Handle1:STN:280:DyaK3M7is1ynsw%3D%3D
WK Moon KH Chang MH Han IO Kim (1999) ArticleTitleIntracranial germinomas: correlation of imaging findings with tumor response to radiation therapy AJR Am J Roentgenol 172 713–716 Occurrence Handle10063866 Occurrence Handle1:STN:280:DyaK1M7mtFKhuw%3D%3D
Y Murai S Kobayashi T Mizunari Y Ohaki K Adachi A Teramoto (2000) ArticleTitleSpontaneous regression of a germinoma in the pineal body after placement of a ventriculoperitoneal shunt J Neurosurg 93 884–886 Occurrence Handle11059673 Occurrence Handle1:STN:280:DC%2BD3crgslynsw%3D%3D
J Murata Y Sawamura J Ikeda S Hashimoto K Honma (1998) ArticleTitleTwenty-four hour rhythm of melatonin in patients with a history of pineal and/or hypothalamo-neurohypophyseal germinoma J Pineal Res 25 159–166 Occurrence Handle9745984 Occurrence Handle1:CAS:528:DyaK1cXmtlCrs7w%3D
EA Neuwelt M Glasberg E Frenkel WK Clark (1979) ArticleTitleMalignant pineal region tumors. A clinico-pathological study J Neurosurg 51 597–607 Occurrence Handle501398 Occurrence Handle1:STN:280:DyaL3c%2FltFehtA%3D%3D
K Nomura (2001) ArticleTitleEpidemiology of germ cell tumors in Asia of pineal region tumor J Neurooncol 54 211–217 Occurrence Handle11767288 Occurrence Handle1:STN:280:DC%2BD38%2FktFWgtw%3D%3D Occurrence Handle10.1023/A:1012771204732
S Oi K Matsuzawa JU Choi DS Kim JK Kang BK Cho (1998) ArticleTitleIdentical characteristics of the patient populations with pineal region tumors in Japan and in Korea and therapeutic modalities Childs Nerv Syst 14 36–40 Occurrence Handle9548339 Occurrence Handle1:STN:280:DyaK1c3gvVWitA%3D%3D Occurrence Handle10.1007/s003810050172
S Oi S Matsumoto (1992) ArticleTitleControversy pertaining to therapeutic modalities for tumors of the pineal region: a worldwide survey of different patient populations Childs Nerv Syst 8 332–336 Occurrence Handle1394280 Occurrence Handle1:STN:280:DyaK3s%2FgvVSltA%3D%3D Occurrence Handle10.1007/BF00296564
S Oi M Shibata J Tominaga Y Honda M Shinoda F Takei R Tsugane K Matsuzawa O Sato (2000) ArticleTitleEfficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study J Neurosurg 93 245–253 Occurrence Handle10930010 Occurrence Handle1:STN:280:DC%2BD3cvhtl2qtg%3D%3D
N Ono I Isobe J Uki H Kurihara T Shimizu K Kohno (1994) ArticleTitleRecurrence of primary intracranial germinomas after complete response with radiotherapy: recurrence patterns and therapy Neurosurgery 35 615–621 Occurrence Handle7528902 Occurrence Handle1:STN:280:DyaK2M7gslCrsg%3D%3D
N Ono I Isobe J Uki H Kurihara LE Kun T Tang J Sty BM Camitta (1981) ArticleTitlePrimary cerebral germinoma and ventriculoperitoneal shunt metastasis Cancer 48 213–216 Occurrence Handle10.1002/1097-0142(19810701)48:1<213::AID-CNCR2820480134>3.0.CO;2-5
N Ono H Naganuma HK Inoue M Tamura (1991) ArticleTitleCerebrospinal fluid placental alkaline phosphatase in the Intracranial germinomas: results of enzyme antigen immunoassay Neurol Med Chir (Tokyo) 31 563–567 Occurrence Handle1:STN:280:DyaK387jtFajsg%3D%3D
R Pallini V Bozzin M Scerrati C Zuppi B Zappacosta GF Rossi (1991) ArticleTitleBone metastasis associated with shunt-related peritoneal deposits from a pineal germinoma. Case report and review of the literature Acta Neurochir (Wien) 109 78–82 Occurrence Handle1:STN:280:DyaK3M3pvVSqtw%3D%3D Occurrence Handle10.1007/BF01405704
AJ Raimondi T Tomita (1982) ArticleTitlePineal tumors in childhood. Epidemiology, pathophysiology, and surgical approaches Childs Brain 9 239–266 Occurrence Handle6179720 Occurrence Handle1:STN:280:DyaL383mtFShtQ%3D%3D Occurrence Handle10.1159/000120060
J Régis P Bouillot F Rouby-Volot D Figarella-Branger H Dufour JC Péragut (1996) ArticleTitlePineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases Neurosurgery 39 907–914 Occurrence Handle8905744 Occurrence Handle10.1097/00006123-199611000-00003
DS Russel LJ Rubinstein (1987) Pathology of tumors of the nervous system EditionNumber5 Williams and Wilkins Baltimore 668–670
K Sano (1990) ArticleTitlePathogenesis of intracranial germ cell tumors reconsidered J Neurosurg 90 258–264
K Sano M Matsutani (1981) ArticleTitlePinealoma (germinoma) treated by direct surgery and postoperative irradiation: a long-term follow up Child Brain 8 81–97 Occurrence Handle1:STN:280:DyaL3M3jsF2jsQ%3D%3D Occurrence Handle10.1159/000119970
Y Sawamura H Shirato J Ikeda M Tada N Ishii T Kato H Abe K Fujieda (1998) ArticleTitleInduction chemotherapy followed by reduced-volume radiation therapy for newly diagnosed central nervous system germinoma J Neurosurg 88 66–72 Occurrence Handle9420074 Occurrence Handle1:CAS:528:DyaK1cXkvFKhug%3D%3D
Y Sawamura N De Tribolet N Ishii H Abe (1997) ArticleTitleManagement of primary intracranial germinomas: diagnostic surgery or radical resection? J Neurosurg 87 262–266 Occurrence Handle9254091 Occurrence Handle1:STN:280:DyaK2szps1Wjtg%3D%3D Occurrence Handle10.3171/jns.1997.87.2.0262
SE Schild BW Scheithauer MG Haddock WW Wong MK Lyons LB Marks MG Norman PC Burger (1996) ArticleTitleHistologically confirmed pineal tumors and other germ cell tumors of the brain Cancer 78 2564–2571 Occurrence Handle8952565 Occurrence Handle1:STN:280:DyaK2s7htVCjtg%3D%3D Occurrence Handle10.1002/(SICI)1097-0142(19961215)78:12<2564::AID-CNCR16>3.0.CO;2-U
J Smirinotopoulos E Rushing H Mena (1992) ArticleTitlePineal region masses: differential diagnosis. From the Archives of the AFIP Radiographics 12 578–579
B Stein M Fetell (1984) ArticleTitleTherapeutic modalities for pineal region tumors Clin Neurosurg 32 445–450
K Sugiyama T Uozumi K Arita K Kiya K Kurisu M Sumida M Harada (1994) ArticleTitleClinical evaluation of 33 patients with histologically verified germinoma Surg Neurol 42 200–210 Occurrence Handle7940105 Occurrence Handle1:STN:280:DyaK2M%2Fis1ertA%3D%3D Occurrence Handle10.1016/0090-3019(94)90263-1
LN Sutton J Radcliffe J Goldwein P Phillips AJ Janss RJ Packer H Zhao (1999) ArticleTitleQuality of Life of adults survivors germinomas treated with craniospinal irradiation Neurosurgery 45 1292–1298 Occurrence Handle10598695 Occurrence Handle1:STN:280:DC%2BD3c%2FmsFOmtg%3D%3D Occurrence Handle10.1097/00006123-199912000-00002
K Takakura (1984) ArticleTitleIntracranial germ cell tumors Clin Neurosurg 32 429–444
N Tamaki D Yin (2000) ArticleTitleTherapeutic strategies and surgical results for pineal region tumors J Clin Neurosci 7 125–128 Occurrence Handle10844797 Occurrence Handle1:STN:280:DC%2BD2cvitl2nug%3D%3D Occurrence Handle10.1054/jocn.1999.0164
K Tokoro Y Chiba S Murase S Yagishita Y Kyuma (1991) ArticleTitleSubarachnoid dissemination of pineal germinoma 9 years after radiation therapy without local relapse – case report Neurol Med Chir (Tokyo) 31 725–728 Occurrence Handle1:STN:280:DyaK387jtFWqsA%3D%3D
GP Trentini A Maiorana A De Benedittis (1985) ArticleTitleMetachronous seminoma of the pineal region and right testis. Case report Appl Pathol 3 129–133 Occurrence Handle3842074 Occurrence Handle1:STN:280:DyaL2s%2Fis1ehsA%3D%3D
J Vaquero J Ramiro R Martinez G Bravo (1992) ArticleTitleNeurosurgical experience with tumors of the pineal region at Clinica Puerta de Hierro Acta Neurochir (Wien) 116 23–32 Occurrence Handle1:STN:280:DyaK38zht1emtQ%3D%3D Occurrence Handle10.1007/BF01541249
HL Weiner RA Lichtenbaum JH Wisoff RB Snow MM Souweidane JN Bruce JL Finlay (2002) ArticleTitleDelayed surgical resection of central nervous system germ cell tumors Neurosurgery 50 727–733 Occurrence Handle11904022 Occurrence Handle10.1097/00006123-200204000-00008
SL Wolden WM Wara DA Larson MD Prados MS Edwards PK Sneed (1995) ArticleTitleRadiation therapy for primary intracranial germ-cell tumors Int J Radiat Oncol Biol Phys 32 943–949 Occurrence Handle7607968 Occurrence Handle1:STN:280:DyaK2Mzjt1Squw%3D%3D Occurrence Handle10.1016/0360-3016(95)00067-9
J Yamashita H Handa (1988) ArticleTitleDiagnosis and treatment of pineal tumors. Kyoto University experience (1941–1984) Acta Neurochir [Suppl] 42 137–141 Occurrence Handle1:STN:280:DyaL1M%2Fks1OgsQ%3D%3D
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Cuccia, V., Galarza, M. Pure pineal germinomas: analysis of gender incidence. Acta Neurochir (Wien) 148, 865–871 (2006). https://doi.org/10.1007/s00701-006-0846-x
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DOI: https://doi.org/10.1007/s00701-006-0846-x