The treatment and prognosis of intracranial nongerminomatous malignant germ cell tumors in pineal region

Abstract

Objective To investigate the clinical feature,treatment and prognosis of intracranial nongerminomatous malignant germ cell tumors (NGMGCTs) in pineal region.Methods Records of 34 such kind patients treated in our hospital between Jan 2000 and Jan 2010 were reviewed retrospectively.Clinical manifestations,diagnosis,treatment and outcome were analyzed in each patient.All tumors were microsurgically removed by occipital transtentorial approach (Poppen) and treated with radiotherapy combined chemotherapy.Results The tumor was totally removed in 32 cases,sub - totally in 2.In these 34 cases,all were verified by pathology,viz.11 immature teratomas,2 teratoma with malignant transformation,6 choriocarcinoma,2 embryonal carcinomas and 1 yolk sac tumors,12 mix germ cell tumors.Thirty - one patients were followed up.The overall 1 - year survival rate was 97％,3 - year survival rate 62％ and 5 -year survival rate 44％.Immature teratomas 1 - year survival rate was 100％,3 - year survival rate 67％.Teratoma with malignant transformation 1 - year survival rate was 100％,1 - year survival rate was 33％.Choriocarcinoma,embryonal carcinomas and yolk sac tumors 1 - year survival rate was 88％,3 - year survival rate 55％,5 - year survival rate 33％.Mix germ cell tumors 1 - year survival rate was 100％,3 -year survival rate 67％,5 - year survival rate 67％.Conclusion The majority of pineal region NGMGCTs can be diagnosed by clinical manifestations,imaging data and tumor markers pre - operatively Surgery remains the first choice for NGMGCT based on tumor histology.Combined regimen of surgical resection,radiotherapy and chemotherapy is mostly effective. Key words: Pineal region; Germ cell tumors; Prognosis; Treatment