Malignant transformation of germinoma 14 years after onset: Favorable efficacy of oral etoposide.

Abstract

We report the case of a 19-year-old woman with a highly malignant intracranial germ cell tumor (GCT) that developed 14 years after treatment for neurohypophyseal germinoma. Magnetic resonance imaging (MRI) showed a large neurohypophyseal mass and a synchronous lesion in the pineal region. Plasma α-fetoprotein was elevated to 3038 ng/mL. Although the tumor shrank and tumor marker levels normalized after chemotherapy and craniospinal irradiation, treatment was switched to oral etoposide for the residual tumor because of adverse events. MRI after oral etoposide introduction showed additional tumor shrinkage for 27 months after the onset of the second tumor. To the best of our knowledge, this is the longest interval between germinoma onset and the development of highly malignant recurrent GCT to be reported in the English-language literature. Oral etoposide prevented regrowth of the GCT, which has a poor prognosis, and decreased the size of the residual tumor.

• Authors: Kohei Fukuoka, Takaaki Yanagisawa, Tomonari Suzuki, Mitsuaki Shirahata, Jun-ichi Adachi, Kazuhiko Mishima, Takamitsu Fujimaki, Masao Matsutani, Ryo Nishikawa
• Journal: Pediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 57 Issue 3 Pg. 483-6 (Jun 2015) ISSN: 1442-200X [Electronic] Australia
• PMID: 25712128 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2015 Japan Pediatric Society.

Chemical References

• Antineoplastic Agents, Phytogenic
• Etoposide

Topics

• Administration, Oral
• Antineoplastic Agents, Phytogenic (administration & dosage)
• Brain Neoplasms (diagnosis, drug therapy)
• Cell Transformation, Neoplastic
• Disease Progression
• Dose-Response Relationship, Drug
• Etoposide (administration & dosage)
• Female
• Forecasting
• Germinoma (diagnosis, drug therapy)
• Humans
• Magnetic Resonance Imaging
• Pituitary Gland, Posterior (pathology)
• Time Factors
• Young Adult