Advances in the management of central nervous system germ cell tumors.

Intracranial germ cell tumors represent a relatively small portion of pediatric central nervous system tumors, with a reported incidence ranging from 3.6% in North America to 15.3% in parts of Asia. They are known to arise in midline locations, most frequently the pineal gland and suprasellar regions, and affect males twice to three times more frequently than females, especially in the case of pineal-region tumors. The median age of diagnosis is 10-12 years. The treatment of intracranial germ cells tumors is complicated by their relative rarity, histologic heterogeneity, and a lack of widespread consensus on their optimal management. Despite these challenges, important progress continues to be made, with a move toward multicenter and international collaborative efforts that offer potential for clinical advancements. This review focuses on recent developments in the management of intracranial germ cell tumors, including updates in diagnosis, surveillance, biology, treatment, and outcomes.