がんの科学と治療

Primary Intracranial Germinoma: A Case Report and Review of Literature

Abstract

Messoudi K, Oualla K, Dkhissi Y, Zouiten O, Benbrahim Z, M’rabet FZ, Arifi S, Maaroufi NM, Amarti A and Mellas

Primary intracranial germinomas (PIGs) are an extremely rare entity with usual location in the pineal and suprasellar regions. Adult cases are rare since they are commonly diagnosed in the second decade of life. Diagnosis is based on specific imaging features in addition to tumor markers, cerebrospinal fluid cytology and stereotactic biopsy. We report a rare case of pineal germinoma diagnosed in adult patient at department by cerebrospinal fluid cytology. The therapeutic strategy was based on neoadjuvant chemotherapy followed by radiotherapy. The patient received chemotherapy based on BEP regimen (bleomycine-etoposide-cisplatin) with a clear clinical benefit from the first cycle of chemotherapy by complete resolution of clinical symptoms. The evolution was marked after the third cycle of chemotherapy by severe febrile pancetopenia leading to septic complications and the death of patient. The aim of this work is to describe the rarity of this case, clinical radiological and histological features, in addition to therapeutic management and discuss them in comparison with literature.