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Intramedullary spinal cord germinoma--2 case reports
Takeshi Aoyama1, Kazutoshi Hida, Nobuaki Ishii
1Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8636, Japan. tataoya@sirius.ocn.ne.jp
Surgical Neurology
|January 27, 2007
Summary
Primary intramedullary spinal cord germinoma is rare but treatable. Successful outcomes were achieved in two patients using ICE chemotherapy and radiotherapy, demonstrating effective management for this rare CNS germinoma.
Area of Science:
- Neuro-oncology
- Spinal Cord Neoplasms
- Germ Cell Tumors
Background:
- Primary intramedullary spinal cord germinoma is an exceptionally rare central nervous system (CNS) tumor.
- This report details a comprehensive management strategy for CNS germinoma, specifically addressing the rare intramedullary spinal cord variant.
- It highlights the first documented successful use of ICE chemotherapy for intramedullary germinoma.
Observation:
- Two patients, a 16-year-old girl and a 34-year-old woman, presented with progressive neurological deficits suggestive of spinal cord lesions.
- Initial imaging revealed spinal cord swelling; diagnoses were initially suspected as astrocytic tumors or other spinal cord tumors.
- Pathological examination confirmed primary germinoma in both cases, with lesions located between T9-T12 and T8-T10 respectively.
Findings:
- Both patients received a combination of ICE chemotherapy (ifosfamide, carboplatin, etoposide) and radiotherapy.
- Case 1 showed no recurrence at 48 months post-treatment, and Case 2 showed no recurrence at 36 months post-treatment.
- Neurological deficits did not worsen, and in one case, initial symptoms like paraparesis and urinary retention showed improvement.
Implications:
- Accurate and timely diagnosis of primary intramedullary spinal cord germinoma is crucial.
- Effective treatment protocols involving chemotherapy and radiotherapy can lead to successful outcomes and prevent neurological deterioration.
- This approach offers a viable and successful management strategy for this rare and challenging tumor type.
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