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Intramedullary recurrence of germinoma in the spinal cord 15 years after complete remission of a pineal lesion.

Abstract
The authors present a case of germinoma that was initially found in the pineal region and recurred 15 years later in the intramedullary cervical spinal cord after intensive chemo- and radiotherapy and diagnosis of complete remission. This 28-year-old man initially presented with seizures. Hydrocephalus and a pineal tumor were found on radiological examination, and partial resection of the tumor was performed. Histological diagnosis showed a pure germinoma. Following surgery, the patient received a combination of chemo- and radiotherapy, and a complete remission was shown. However, after 15 years of follow-up, he presented with gait disturbances. Spinal MRI showed an intramedullary mass lesion in the cervical spinal cord. The cervical lesion was biopsied, and histological examination again revealed a pure germinoma. With germinomas, the possibility of a drop metastasis from an intracranial lesion to the spinal cord must be considered during follow-up. However, in the present case, analysis of a CSF sample showed no abnormalities as in previously published cases. In recent years, multidisciplinary treatments have demonstrated good event-free survival rates in cases of pure germinomas, but long-term outcomes over the decades are not fully known. Continual follow-up of such cases is recommended even after complete remission has been achieved.
AuthorsShunya Hanakita, Atumi Takenobu, Atsushi Kambe, Takashi Watanabe, Masahiro Shin, Akira Teraoka
JournalJournal of neurosurgery. Spine (J Neurosurg Spine) Vol. 16 Issue 5 Pg. 513-5 (May 2012) ISSN: 1547-5646 [Electronic] United States
PMID22360562 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Brain Neoplasms (pathology, therapy)
  • Germinoma (secondary, therapy)
  • Humans
  • Male
  • Pineal Gland
  • Spinal Cord Neoplasms (secondary, therapy)
  • Time Factors

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