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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Primitive intracranial trigeminal nerve germinoma. Case report]
B Baussart1, J-F Lepeintre, S Condette-Auliac
1Service de neurochirurgie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France. bertranbaussart@yahoo.fr
Neuro-Chirurgie
|March 6, 2007
Summary
This case study details a rare intracranial trigeminal nerve germinoma in a young man. Successful treatment with chemotherapy and radiotherapy led to complete remission, highlighting a novel therapeutic approach for this uncommon brain tumor.
Area of Science:
- Neuro-oncology
- Pathology
Background:
- Primitive intracranial germinomas are rare malignant tumors typically affecting the pineal and hypothalamic regions.
- This report focuses on an unusual case of germinoma originating in the trigeminal nerve pathway.
Observation:
- A 22-year-old male presented with headache, asthenia, weight loss, and rapidly worsening trigeminal hypoesthesia.
- Radiological imaging revealed an enhanced lesion in the cavernous sinus extending into the Meckel cave.
- Histological analysis confirmed a primitive non-secreting intracranial germinoma, with negative tumor markers.
Findings:
- The patient underwent partial tumor resection via a temporo-pterional approach.
- Combined chemotherapy (carboplatin, ifosfamide, etoposide) followed by focal fractionated radiotherapy (40 Gy) was administered.
- Complete clinical and radiological remission was achieved five years post-treatment.
Implications:
- This case expands the known anatomical locations for primitive intracranial germinomas.
- It underscores the efficacy of multimodal treatment (chemotherapy and radiotherapy) for this rare tumor.
- The findings suggest that trigeminal nerve involvement should be considered in the differential diagnosis of intracranial lesions presenting with cranial nerve deficits.
