Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Germ cell tumors of the thalamus and the basal ganglia

Abstract

Two cases of germ cell tumors (GCTs) of the basal ganglia are presented and 40 previously reported cases are reviewed. The incidence of GCTs of the basal ganglia and thalamus was estimated as less than 14% of all intracranial GCTs. All patients except for two (95%) were male, aged 7–19 years. The clinical course was usually slow. The major symptoms were hemiparesis, mental deterioration such as dementia or character change, precocious puberty, diabetes insipidus, oculomotor palsy, speech disturbance, and hemianopsia. Signs of intracranial hypertension did not occur until the late stages of the disease. The plain CT finding was characterized by an irregularly defined, slightly high-density area frequently accompanied by central low-density areas without significant mass effect. The tumors showed mild to moderate and nonhomogeneous contrast enhancement. An ipsilateral cerebral hemiatrophy was often found. MR images demonstrated the corresponding findings. GCTs of the basal ganglia had a high possibility of containing components other than germinoma such as choriocarcinoma, endodermal sinus tumor, and embryonal carcinoma. Thus, tumor markers in the serum, CSF, or cyst fluid were frequently positive. With recent refinement of microsurgical techniques as well as immunohistochemical study and measurements of tumor markers of serum, CSF, and cyst fluid, major resections of tumor, accurate pretreatment histologic diagnosis, and early determination of the specific types of this tumor appear to be readily possible. This is essential for effective treatment of patients not only with radiosensitive germinoma, but also those with radioinsensitive nongerminoma variants and a combination of them located in this region.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Albrechtsen R, Klee JG, Moeller JE (1972) Primary intracranial germ cell tumors including five cases of endodermal sinus tumor. Acta Pathol Microbiol Scand [A] 80 [Suppl 233]:32–38

  2. 2.

    Allen JC (1987) Management of primary intracranial germ cell tumors of childhood. Pediatr Neurosci 13:152–157

  3. 3.

    Allen JC, Nisselbaum J, Epstein F, Rosen G, Schwartz MK (1979) Alphafetoprotein and human chorionic gonadotropin determination in cerebrospinal fluid. J Neurosurg 51: 368–374

  4. 4.

    Araki C, Matsumoto S (1969) Statistical reevaluation of pinealoma and related tumors in Japan. J Neurosurg 30:146–149

  5. 5.

    Arseni C (1958) Tumors of the basal ganglia. Arch Neurol Psychiatry 80:18–24

  6. 6.

    Chang CG-S, Kageyama N, Kobayashi T, Yoshida J, Negro M (1981) Pineal tumors: clinical diagnosis, with special emphasis on the significance of pineal calcification. Neurosurgery 8:656–668

  7. 7.

    Dixon FJ, Moore RA (1952) Tumors of the male sex organs. (Atlas of tumor pathology, sect VIII, Fasc 31 b and 32). Armed Forces Institute of Pathology, Washington, DC

  8. 8.

    Hirotsu T, Ota H, Matsukawa K, Tada S, Yamaguchi Y (1987) A case of intracranial germ cell tumor with slowly progressive course and ipsilateral cerebral hemiatrophy. Tokyo Jikeikai Med J 102:1861–1869

  9. 9.

    Hoshino N (1953) Ectopic pinealoma. Report of three cases. Arch Jpn Chir 22:145–147

  10. 10.

    Ikeda Y, Higuchi H, Chin M, Shimura T, Nakazawa S (1980) A case of thalamic germinoma with crossed aphasia in a dextral. Neurol Surg 8:859–864

  11. 11.

    Jellinger K (1973) Primary intracranial germ cell tumors. Acta Neuropathol (Berl) 25:291–306

  12. 12.

    Kobayashi S, Kojo N, Miyagi J, Anegawa S, Katayama M, Sugita Y, Uegaki M, Kuramoto S (1985) A case of primary intracranial embryonal carcinoma arising in the right basal ganglia. Nerv Syst Child 10:283–288

  13. 13.

    Kobayashi T, Kageyama N, Kida Y, Yoshida J, Shibuya N, Okamura K (1981) Unilateral germinomas involving the basal ganglia and thalamus. J Neurosurg 55:55–62

  14. 14.

    Kurman RJ, Scardino PT, McIntire KR, Waldmann TA, Javadpour N (1977) Cellular localization of alphafetoprotein and human chorionic gonadrotropin in germ cell tumors of the testis using an indirect immunoperoxidase technique. A new approach to classification utilizing tumor markers. Cancer 40:2136–2151

  15. 15.

    Kwak R, Suzuki J (1970) Two cases of thalamic tumor with ipsilateral cerebral hemiatrophy. Brain Nerve 22:1439–1446

  16. 16.

    Kwak R, Saso S-I, Suzuki J (1978) Ipsilateral cerebral atrophy with thalamic tumor of childhood. J Neurosurg 48:443–449

  17. 17.

    Mabuchi S, Abe H, Nakagawa Y, Aida T, Tashiro K, Tsuru M (1982) Germinoma originating in the basal ganglia — report of 2 cases. Neurol Surg 10:977–982

  18. 18.

    Maehara T, Machida T, Tsuchiya K, Iio M (1983) Brain tumors with ipsilateral cerebral hemiatrophy. AJNR 4:478–480

  19. 19.

    Matsumoto K, Ohta K, Matsumoto A (1971) A case of large thalamic tumor (pinealoma) with dystonic movement of unilateral limbs. Clin Neurol 11:373–379

  20. 20.

    Moriyama T, Teramoto S, Kitajima H, Yonekawa M, Nakamura H, Matsumura H (1983) Primary intracranial germ cell tumors in the right basal ganglia and its vicinity area — a report of the case with germinoma and choriocarcinoma histologically. Neurol Surg 11:73–80

  21. 21.

    Nakagawa Y, Hamazima I, Iwasaki Y, Yada K, Kunita H (1973) Ipsilateral cerebral atrophy caused by ectopic pinealoma: report of a case. Brain Nerve 25:69–75

  22. 22.

    Nishiyama RH, Batsakis JG, Weaver DK, Simrall JH (1966) Germinal neoplasms of the central nervous system. Arch Neurol 93:342–347

  23. 23.

    Nonaka T, Shimabukuro H, Oguro K, Sato F, Masuzawa T (1987) Germ cell tumors originating in the basal ganglia and thalamus. Neurol Med Chir (Tokyo) 27:1098–1103

  24. 24.

    Numabe T, Kamioka Y (1963) A case of ectopic pinealoma. Brain Nerve 15:793–800

  25. 25.

    Okada K, Kawano N, Takagi H, Ohwada T, Yada K, Atari E (1980) Teratocarcinoma in basal ganglia. A case report of total removal. Nerv Syst Child 5:243–248

  26. 26.

    Ono N, Inoue HK, Naganuma H, Misumi S, Tamura M (1986) Germ cell tumor in the basal ganglia: immunohistochemical demonstration of alfa-fetoprotein, human chorionic gonadotropin, and carcinoembryonic antigen. Surg Neurol 25:495–500

  27. 27.

    Saitoh Y, Arita N, Ushio Y, Koshino K, Ikeda T, Mogami H (1983) Germ cell tumors in the basal ganglia with elicited serum and CSF alphafetoprotein levels. Brain Nerve 35:935–939

  28. 28.

    Sano K (1976) Pinealoma in children. Child's Brain 2:67–72

  29. 29.

    Sano K, Matsutani M (1981) Pinealoma (germinoma) treated by direct surgery and postoperative irradiation. A long-term follow-up. Child's Brain 8:81–97

  30. 30.

    Shokry A, Janzer RC, Von Hochstatter AR, Yasagil MG, Hedinger C (1985) Primary intracranial germ-cell tumors. A clinicopathological study of 14 cases. J Neurosurg 62:826–830

  31. 31.

    Soejima T, Takeshita I, Yamamoto H, Tsukamoto Y, Fukui M, Matsumoto S (1987) Computed tomography of germinomas in basal ganglia and thalamus. Neuroradiology 29:366–370

  32. 32.

    Suzuki J, Kowada M, Ouchi K, Narita A (1961) A case of ectopic pinealoma diffusely infiltrated to left thalamic region with successful total extirpation. Brain Nerve 13:615–620

  33. 33.

    Tanaka R, Ueki K (1979) Germinomas in the cerebral hemisphere. Surg Neurol 12:239–241

  34. 34.

    Teilum G (1965) Classification of endodermal sinus tumors (mesoblastoma vitellinum) and so-called “embryonal carcinoma” of the ovary. Acta Pathol Microbiol Scand 64:407–429

  35. 35.

    Waga S, Handa H, Yamashita J (1979) Intracranial germinomas. Treatment and results. Surg Neurol 11:167–172

  36. 36.

    Yamada H, Imamura K, Sakai N, Ando T, Hirata T, Misao H, Sakato K, Shimokawa K (1980) Intracranial germinoma developing in the right basal ganglia. Report of a case followed up by CT scans-a review of the literature. Brain Nerve 32:387–392

Download references

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tamaki, N., Lin, T., Shirataki, K. et al. Germ cell tumors of the thalamus and the basal ganglia. Child's Nerv Syst 6, 3–7 (1990). https://doi.org/10.1007/BF00262257

Download citation

Key words

  • Germ cell tumors
  • Germinoma
  • Chriocarcinoma
  • Endodermal sinus tumor
  • Embryonal carcinoma
  • Basal ganglia
  • Thalamus