Germinoma

At a germinoma is a germ cell tumor of the central nervous system (CNS). Its histology corresponds to the dysgerminoma in the ovary and seminoma of the testis. About 75 % of patients are old at diagnosis 10-20 years. The tumor usually speaks very well to radiation or chemotherapy.

Forecast

The 5- year survival rate is 90%.

Diagnostics

In more than 80% of the tumor in the midline is in the region of the pineal gland, but up to 5 % of the tumors occur multifocal. The diagnosis is usually made ​​by biopsy. The determination of beta- HCG and AFP in the cerebrospinal fluid is groundbreaking.

Histology

The germinoma is characterized by a planar cohesive growth. The large tumor cells with clear cytoplasm often have prominent nucleoli and are divided by septa into lobules. These septa are usually filled by numerous lymphocytes. In a rare, but prognostically unfavorable subtype also syncytiotrophoblast (beta- HCG positive) are observed. Immunohistochemistry can the tumor cells by their expression of placental alkaline phosphatase ( PLAP ), c- Kit, Oct-4 and identified in rare cases cytokeratin.

Treatment

A combined radiotherapy and chemotherapy with carboplatin, etoposide and bleomycin is curative.