Masayuki Kanamori1, Hirokazu Takami2,3, Shigeru Yamaguchi4, Takashi Sasayama5, Koji Yoshimoto6, Teiji Tominaga1, Akihiro Inoue7, Naokado Ikeda8, Atsushi Kambe9, Toshihiro Kumabe10, Masahide Matsuda11, Shota Tanaka3, Manabu Natsumeda12, Ken-Ichiro Matsuda13, Masahiro Nonaka14, Jun Kurihara15, Masayoshi Yamaoka16, Naoki Kagawa17, Naoki Shinojima18, Tetsuya Negoto19, Yukiko Nakahara20, Yoshiki Arakawa21, Seiji Hatazaki22, Hiroaki Shimizu23, Atsuo Yoshino24, Hiroshi Abe25, Jiro Akimoto26, Yu Kawanishi27, Tomonari Suzuki28, Atsushi Natsume29, Motoo Nagane30, Yukinori Akiyama31, Dai Keino32, Tadateru Fukami33, Takahiro Tomita34, Kohei Kanaya35, Tsutomu Tokuyama36, Shuichi Izumoto37, Mitsutoshi Nakada38, Daisuke Kuga39, Shohei Yamamoto40, Ryogo Anei41, Takeo Uzuka42, Junya Fukai43, Noriyuki Kijima44, Keita Terashima45, Koichi Ichimura2, Ryo Nishikawa28. 1. Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 2. Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan. 3. Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 4. Department of Neurosurgery, Faculty of Medicine, Hokkaido University, Sapporo, Japan. 5. Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan. 6. Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. 7. Department of Neurosurgery, Ehime University Graduate School of Medicine, Ehime, Japan. 8. Department of Neurosurgery and Neuroendovascular Surgery, Osaka Medical College, Osaka, Japan. 9. Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, Japan. 10. Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Japan. 11. Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 12. Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan. 13. Department of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata, Japan. 14. Department of Neurosurgery, Kansai Medical University, Osaka, Japan. 15. Department of Neurosurgery, Saitama Children's Medical Center, Saitama, Japan. 16. Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan. 17. Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan. 18. Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan. 19. Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan. 20. Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan. 21. Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 22. Department of Neurosurgery, Mie University Graduate School of Medicine, Mie, Japan. 23. Department of Neurosurgery, Akita University Graduate School of Medicine, Akita, Japan. 24. Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan. 25. Department of Neurosurgery, Fukuoka University, Fukuoka, Japan. 26. Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan. 27. Department of Neurosurgery, Kochi Medical School, Kochi University, Nankoku, Japan. 28. Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan. 29. Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan. 30. Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan. 31. Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan. 32. Division of Hematology/Oncology, Kanagawa Children`s Medical Center, Yokohama, Japan. 33. Department of Neurosurgery, Shiga University of Medical Science, Otsu, Shiga, Japan. 34. Department of Neurosurgery, University of Toyama, Toyama, Japan. 35. Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. 36. Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan. 37. Department of Neurosurgery, Kindai University Faculty of Medicine, Sayama, Japan. 38. Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. 39. Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 40. Department of Pediatrics, Showa University Fujigaoka Hospital, Kanagawa, Japan. 41. Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan. 42. Department of Neurosurgery, Dokkyo Medical University, Tochigi, Japan. 43. Department of Neurological Surgery, Wakayama Medical University School of Medicine Wakayama, Japan. 44. Department of Neurosurgery, Osaka National Hospital, Osaka, Japan. 45. Division of Neuro-Oncology, National Center for Child Health and Development, Tokyo, Japan.
Abstract
BACKGROUND: The Delphi consensus statements on the management of germ cell tumors (GCTs) failed to reach agreements on the statement that the cases with (i) pineal and neurohypophyseal bifocal lesion, (ii) with diabetes insipidus, and (iii) with negative tumor markers can be diagnosed as germinoma without histological verification. To answer this, multicenter retrospective analysis was performed. METHODS: A questionnaire on clinical findings, histological diagnosis, and details of surgical procedures was sent to 86 neurosurgical and 35 pediatrics departments in Japan. RESULTS: Fifty-one institutes reported 132 cases that fulfilled the 3 criteria. Tissue sampling was performed in 91 cases from pineal (n = 44), neurohypophyseal (n = 32), both (n = 6), and distant (n = 9) lesions. Histological diagnosis was established in 89 cases: pure germinoma or germinoma with syncytiotrophoblastic giant cells in 82 (92.1%) cases, germinoma and mature teratoma in 2 cases, and granulomatous inflammation in 2 cases. Histological diagnosis was not established in 2 cases. Although no tumors other than GCTs were identified, 3 (3.4%) patients had non-germinomatous GCTs (NGGCTs). None of the patients developed permanent complications after endoscopic or stereotactic biopsy. Thirty-nine patients underwent simultaneous procedure for acute hydrocephalus without permanent complications, and hydrocephalus was controlled in 94.9% of them. CONCLUSION: All patients who fulfilled the 3 criteria had GCTs or granulomatous inflammation, but not other types of tumors. However, no fewer than 3.4% of the patients had NGGCTs. Considering the safety and the effects of simultaneous procedures for acute hydrocephalus, biopsy was recommended in such patients.
BACKGROUND: The Delphi consensus statements on the management of germ cell tumors (GCTs) failed to reach agreements on the statement that the cases with (i) pineal and neurohypophyseal bifocal lesion, (ii) with diabetes insipidus, and (iii) with negative tumor markers can be diagnosed as germinoma without histological verification. To answer this, multicenter retrospective analysis was performed. METHODS: A questionnaire on clinical findings, histological diagnosis, and details of surgical procedures was sent to 86 neurosurgical and 35 pediatrics departments in Japan. RESULTS: Fifty-one institutes reported 132 cases that fulfilled the 3 criteria. Tissue sampling was performed in 91 cases from pineal (n = 44), neurohypophyseal (n = 32), both (n = 6), and distant (n = 9) lesions. Histological diagnosis was established in 89 cases: pure germinoma or germinoma with syncytiotrophoblastic giant cells in 82 (92.1%) cases, germinoma and mature teratoma in 2 cases, and granulomatous inflammation in 2 cases. Histological diagnosis was not established in 2 cases. Although no tumors other than GCTs were identified, 3 (3.4%) patients had non-germinomatous GCTs (NGGCTs). None of the patients developed permanent complications after endoscopic or stereotactic biopsy. Thirty-nine patients underwent simultaneous procedure for acute hydrocephalus without permanent complications, and hydrocephalus was controlled in 94.9% of them. CONCLUSION: All patients who fulfilled the 3 criteria had GCTs or granulomatous inflammation, but not other types of tumors. However, no fewer than 3.4% of the patients had NGGCTs. Considering the safety and the effects of simultaneous procedures for acute hydrocephalus, biopsy was recommended in such patients.
Authors: Ayal A Aizer; Roshan V Sethi; E Tessa Hedley-Whyte; David Ebb; Nancy J Tarbell; Torunn I Yock; Shannon M Macdonald Journal: Neuro Oncol Date: 2013-05-02 Impact factor: 12.300
Authors: Ivan Chi Hin Siu; Noel Ching Yan Chan; Xian Lun Zhu; Ryan Pak To Yuen; Zhexi He; Danny Tat Ming Chan Journal: Neuroophthalmology Date: 2022-02-15