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Recurrent pure CNS germinoma with markedly elevated serum and cerebrospinal fluid human chorionic gonadotropin-beta
Soumen Khatua1, Andrew Phillips, Jason Fangusaro
1Neural Tumors Program, Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles, Los Angeles, CA, USA. soumen.khatua@imail.org
Abstract:
Controversy continues regarding what level of serum and/or cerebrospinal fluid (CSF) human chorionic gonadotrophin-beta (HCGβ) is consistent with pure germinoma of the central nervous system (CNS). We report a 10-year female with biopsy-proven pure germinoma and normal serum and CSF HCGβ who experienced subsequent biopsy-proven recurrences of germinoma. At recurrence, serum and CSF HCGβ levels were 560 and 3,202 mIU/ml, respectively, although final autopsy demonstrated pure germinoma. This case illustrates the need to re-evaluate the assumption that pathologically pure germinomas may be associated with high levels of HCGβ which are unrelated to nongerminomatous germ cell tumor (NGGCT)/choriocarcinomatous elements.
