Paulo Moacir Mesquita Filho1, Fabio Pires Santos2, Luiza Rech Köhler3, Gregori Manfroi4, Fernanda De Carli4, Moises Augusto de Araujo5, Daniela Schwingel6. 1. Department of Neurosurgery, Hospital da Cidade de Passo Fundo, Passo Fundo, Brazil; Neurology and Neurosurgery Service (SNN), Passo Fundo, Brazil; Academic League of SNN (LASNN), Passo Fundo, Brazil; Medical School, University of Passo Fundo, Passo Fundo, Brazil. 2. Department of ENT Surgery, Hospital da Cidade de Passo Fundo, Passo Fundo, Brazil; Medical School, University of Passo Fundo, Passo Fundo, Brazil. 3. Academic League of SNN (LASNN), Passo Fundo, Brazil; Medical School, University of Passo Fundo, Passo Fundo, Brazil. Electronic address: luizaakohler@gmail.com. 4. Academic League of SNN (LASNN), Passo Fundo, Brazil; Medical School, University of Passo Fundo, Passo Fundo, Brazil. 5. Department of Neurosurgery, Hospital da Cidade de Passo Fundo, Passo Fundo, Brazil. 6. Pathology Institute of Passo Fundo, Passo Fundo, Brazil.
Abstract
BACKGROUND: Germinomas are rare malignant central nervous system tumors, a type of germ cell tumor, according to the 2016 World Health Organization Classification of Brain Tumors. Most of these tumors develop along the midline, most often from the pineal gland, followed by tumors arising in the suprasellar cisterns. Suprasellar germinomas commonly manifest with diabetes insipidus, visual impairment, and hypothalamic-pituitary failure. We present a literature review from the PubMed database and report 2 cases of suprasellar germinomas. CASE DESCRIPTION: Both pediatric patients presented with progressive visual loss; one did not show endocrinologic impairment, and the other presented with hypothyroidism, diabetes insipidus, and generalized edema. Magnetic resonance imaging showed expansive suprasellar masses in both cases, confirmed as germinomas at histopathologic examination. The patients were treated with the same surgical approach, although their outcomes were different because of endocrinologic and post surgical complications. CONCLUSIONS: Suprasellar germinomas are highly curable lesions when diagnosed early. The treatment remains controversial and should be individualized, but the association of chemotherapy and radiotherapy allows reduce adverse effects and shows great results.
BACKGROUND:Germinomas are rare malignant central nervous system tumors, a type of germ cell tumor, according to the 2016 World Health Organization Classification of Brain Tumors. Most of these tumors develop along the midline, most often from the pineal gland, followed by tumors arising in the suprasellar cisterns. Suprasellar germinomas commonly manifest with diabetes insipidus, visual impairment, and hypothalamic-pituitary failure. We present a literature review from the PubMed database and report 2 cases of suprasellar germinomas. CASE DESCRIPTION: Both pediatric patients presented with progressive visual loss; one did not show endocrinologic impairment, and the other presented with hypothyroidism, diabetes insipidus, and generalized edema. Magnetic resonance imaging showed expansive suprasellar masses in both cases, confirmed as germinomas at histopathologic examination. The patients were treated with the same surgical approach, although their outcomes were different because of endocrinologic and post surgical complications. CONCLUSIONS:Suprasellar germinomas are highly curable lesions when diagnosed early. The treatment remains controversial and should be individualized, but the association of chemotherapy and radiotherapy allows reduce adverse effects and shows great results.