Memory deficits in patients with pediatric CNS germ cell tumors

Abstract

Germ cell tumors (GCT) of the central nervous system including germinomas and nongerminomatous germ cell tumors are rare neoplasms most commonly affecting children and adolescents. Many GCT patients seen at The Children's Hospital Denver complain of memory difficulties at the time of presentation, or demonstrate memory difficulties when assessed. Although case studies suggest that memory deficits may be associated with GCT, this is the first study to investigate memory function across a series of pediatric intracranial GCT patients. A total of 26 GCT patients were retrospectively examined for diagnosis, imaging results, intelligence quotient, treatment variables, evidence of increased intracranial pressure at diagnosis, and memory function. Patient Full Scale IQ was measured using the Wechsler intelligence scales. Memory was evaluated with the California Verbal Learning Test. The incidence of amnesia in GCT patients was 42%. GCT patients with amnesia were significantly older at diagnosis than those who did not develop amnesia. There was no association between hydrocephalus at presentation or having received radiation and the presence of memory deficits. Several cases of amnesia were not associated with involvement of classic memory structures. The high incidence of measurable memory deficits in GCT patients suggests that amnesia may be a significant risk in this patient population. Memory assessment at diagnosis and appropriate follow-up services may prove beneficial for GCT patients.