Systemic metastases in primary intracranial germinoma. Case report and literature review.

Systemic metastases from central nervous system germinomas are exceedingly rare, and when they occur lead to fatal outcomes. The authors report the case of a 10-year-old girl who presented with metastatic involvement of the rib and pelvis 2.5 years after surgical resection and radiation therapy for a suprasellar dysgerminoma. After combination chemotherapy, the patient remains disease-free 30 months after relapse. This case provides evidence that chemotherapy can be an effective therapeutic alternative to the use of radiation in the treatment of children with extracranial germinomas.