Dec 1, 2017
Third Ventricle Germ Cell Tumor Originating from the Infundibulum with Rapidly Expansive Enlargement
Pediatric Neurosurgery
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- Volume
- 53
- Number
- 1
- First page
- 49
- Last page
- 54
- Language
- English
- Publishing type
- Research paper (scientific journal)
- DOI
- 10.1159/000480021
- Publisher
- S. Karger AG
We present a pediatric case of a rapidly expanding third ventricle germ cell tumor (GCT). A 14-year-old boy suffered from gradual-onset central diabetes insipidus (DI) and received desmopressin treatment. Magnetic resonance imaging (MRI) showed nonspecific findings of the pituitary-hypothalamic axis. Nine months after the initial DI diagnosis, he developed progressively worsening headache. MRI demonstrated a third ventricle tumor causing noncommunicating hydrocephalus, although an MRI 16 weeks before admission did not show the lesion. We performed gross total resection (GTR) of the tumor in 2 stages: a translamina terminalis approach and an extended transsphenoidal approach. The lesion was histologically diagnosed as immature teratoma with some germinoma. His noncommunicating hydrocephalus resolved after surgery. Through postoperative radiochemotherapy (whole ventricle: 23.4 Gy/13 fractions, tumor bed: 27.0 Gy/15 fractions, and 3 courses of carboplatin-etoposide), he has was in complete remission at the 3-year follow-up and has continued his high school program. This case suggests the following: (1) a mixed GCT originating from the neurohypophysis/infundibulum can show rapidly expansive growth in a child with central DI
(2) GTR and adjuvant radiochemotherapy can result in a good therapeutic outcome in rapidly expanding GCT
and (3) the extended transsphenoidal approach is a complementary approach to transcranial resection of anterior third ventricle GCTs.
(2) GTR and adjuvant radiochemotherapy can result in a good therapeutic outcome in rapidly expanding GCT
and (3) the extended transsphenoidal approach is a complementary approach to transcranial resection of anterior third ventricle GCTs.
- Link information
- ID information
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- DOI : 10.1159/000480021
- ISSN : 1423-0305
- ISSN : 1016-2291
- Pubmed ID : 28946146
- SCOPUS ID : 85030166017