Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (2): 222-226. doi: 10.19723/j.issn.1671-167X.2022.02.004

Previous Articles     Next Articles

Clinical analysis of 30 cases of basal ganglia germinoma in children

WANG Shu-lei,GAO Yang-xu,ZHANG Hong-wu,YANG Hai-bo,LI Hui,LI Yu,SHEN Li-xue,YAO Hong-xin()   

  1. Department of Pediatric Surgery, Peking University First Hospital, Beijing 100034, China
  • Received:2021-05-28 Online:2022-04-18 Published:2022-04-13
  • Contact: Hong-xin YAO E-mail:yaohongxin2012@sina.com

RICH HTML

 19   

PDF (PC)

141

Abstract:

Objective: To summarize and analyze the clinical characteristics of children with basal ganglia germinoma and to improve the level of early clinical diagnosis. Methods: The clinical data of children diagnosed with basal ganglia germinoma admitted to the Pediatric Surgery Ward of Peking University First Hospital from January 2013 to December 2020 were retrospectively analyzed,and descriptive statistics were used to analyze the clinical characteristics of children with basal ganglia germinoma. Results: A total of 30 patients were included in the study, 28 were male, 2 were female, the mean age at onset was (9.7±2.2) years, the median disease duration was 7 months, 27 had unilateral disease, and 3 had bilateral disease. The clinical manifestations were decreased limb muscle strength, cognitive function disorders, polydipsia, precocious puberty, intracranial hypertension, dysphonia and swallowing dysfunction. The serum and cerebrospinal fluid tumor marker alpha-fetoprotein (AFP) were normal in the 30 patients, and the serum and cerebrospinal fluid tumor marker β-human chorionic gonadotropin (β-HCG) were normal in 8 patients.The serum β-HCG was normal in 11 patients but the cerebrospinal fluid β-HCG was slightly elevated, and the serum and cerebrospinal fluid β-HCG were slightly elevated in 11 patients. A total of 33 lesions with irregular shapes were found by imaging examination, including 15 (45.5%) patchy lesions, 10 (30.3%) patchy lesions, and 8 (24.2%) round-like high-density lesions. Tumors showed obvious high-density shadows on computed tomography (CT) scan. Magnetic resonance imaging (MRI) scan of the tumors showed low or isointensity on T1WI and isointensity on T2WI, accompanied by mild peritumoral edema, hemispheric atrophy, cerebral peduncle atrophy, calcification, cystic degeneration,ventricular dilatation and wallerian degeneration. On contrast-enhanced scans, the tumor showed no enhancement or heterogeneous enhancement. Conclusion: The main age of onset of germ cell tumors in the basal ganglia in children is about 10 years old, and males are absolutely dominant. The clinical features and imaging manifestations have certain characteristics. With both combined, the early diagnosis of germ cell tumors in the basal ganglia can be improved.

Key words: Germinoma, Tumor maker, X-ray computed tomography, Magnetic resonance imaging

CLC Number: 

  • R725

Figure 1

Typical case 1(male,10 years old,early tumor) A,CT plain scan showed a slightly density mass in the left basal ganglia, with a CT value of about 41 HU, and the boundary was unclear; B,the mass in the left basal ganglia was hypo-intense on T1WI;C,the mass in the left basal ganglia was hyper-intense on T2WI;D,contrast-enhanced on axial T1WI showed inhomogeneous enhancement;E,caudex encephali was atrophy on axial T2WI.Arrow show the tumors."

Figure 2

Typical case 2(male,10 years old, advanced tumor) A,CT plain scan showed a high density mass in the left basal ganglia,with cystic degeneration;B,the mass in the left basal ganglia was iso-intense on T1WI;C,the mass in the left basal ganglia was hyper-intense on T2WI,with no obvious peritumoral brain edema;D,enhanced MR enhanced lesion showed heterogeneous enhancement. Arrow show the tumors."

[1] Woo PYM, Chu ACH, Chan KY, et al. Progressive hemiparesis in a young man: hemicerebral atrophy as the initial manifestation of basal ganglia germinoma[J]. Asian J Neurosurg, 2017, 12(1):65-68.
doi: 10.4103/1793-5482.145083
[2] Fetcko K, Dey M. Primary central nervous system germ cell tumors: a review and update[J]. Med Res Arch, 2018, 6(3):1719.
[3] Sonoda Y, Kumabe T, Sugiyama S, et al. Germ cell tumors in the basal ganglia: problems of early diagnosis and treatment[J]. J Neurosurg Pediatr, 2008, 2(2):118-124.
doi: 10.3171/PED/2008/2/8/118
[4] Byun HK, Yoon HI, Cho J, et al. Optimization of intracranial germinoma treatment: radiotherapy alone with reduced volume and dose[J]. Int J Radiat Oncol Biol Phys, 2020, 108(3):657-666.
doi: 10.1016/j.ijrobp.2020.05.019
[5] Wei XH, Shen HC, Tang SX, et al. Radiologic features of primary intracranial ectopic germinomas: case reports and literature review[J]. Medicine (Baltimore), 2016, 95(52):e5543.
doi: 10.1097/MD.0000000000005543
[6] Tso WW, Yung AW, Lau HY, et al. Basal ganglia germinoma: MRI classification correlates well with neurological and cognitive outcome[J]. J Pediatr Hematol Oncol, 2014, 36(7):443-447.
[7] Ogino H, Shibamoto Y, Takanaka T, et al. CNS germinoma with elevated serum human chorionic gonadotropin level: clinical characteristics and treatment outcome[J]. Int J Radiat Oncol Biol Phys, 2005, 62(1):803-808.
doi: 10.1016/j.ijrobp.2004.10.026
[8] Reddy MP, Saad AF, Doughty KE, et al. Intracranial germinoma[J]. Proc (Bayl Univ Med Cent), 2015, 28(1):43-45.
[9] 程龙飞, 吴嘉铭, 张茂营, 等. 儿童基底节生殖细胞瘤的早期诊断和治疗[J]. 中国临床解剖学杂志, 2019, 37(2):190-195.
[10] Takeda N, Fujita K, Katayama S, et al. Germinoma of the basal ganglia. An 8 year asymptomatic history after detection of abnormality on CT[J]. Pediatr Neurosurg, 2004, 40(6):306311.
[11] Vialatte D, Bielle F, Mokhtari K, et al. Basal ganglia germinoma in an adult[J]. World Neurosurg, 2016, 92: 584.e11-584.e14.
[12] Kang YM, Lin SC, Lee YY, et al. A single-center study of treatment outcomes of pediatric basal ganglia germinoma in Taiwan[J]. Child’s Nerv Syst, 2020, 36(8):1745-1753.
doi: 10.1007/s00381-020-04543-4
[13] Wong TT, Chen YW, Guo WY, et al. Germinoma involving the basal ganglia in children[J]. Child’s Nerv Syst, 2008, 24(1):71-78.
doi: 10.1007/s00381-007-0495-2
[14] Phi JH, Cho BK, Kim SK, et al. Germinomas in the basal gang-lia: magnetic resonance imaging classification and the prognosis[J]. J Neurooncol, 2010, 99(2):227-236.
doi: 10.1007/s11060-010-0119-7
[15] Konovalov AN, Kadyrov SU, Tarasova EM, et al. Basal ganglia germinomas in children. Four clinical cases and a literature review[J]. Zh Vopr Neirokhir Im N N Burdenko, 2016, 80(1):71-82.
[16] Louis DN, Perry A, Reifenberger G, et al. The 2016 world health organization classification of tumors of the central nervous system: a summary[J]. Acta Neuropathol, 2016, 131(6):803-820.
doi: 10.1007/s00401-016-1545-1
[17] Fujimaki T, Mishima K, Asai A, et al. Levels of beta-human chorionic gonadotropin in cerebrospinal fluid of patients with malignant germ cell tumor can be used to detect early recurrence and monitor the response to treatment[J]. Jpn J Clin Oncol, 2000, 30(7):291-294.
pmid: 11007160
[18] 张大千, 李桥, 何慧瑾, 等. 基底节区生殖细胞瘤的MRI 和MRS征象分析[J]. 中国医学计算机成像杂志, 2017, 23(2):101-106.
[19] 夏正荣, 刘明, 曹雯君, 等. 儿童及青少年颅内生殖细胞瘤的临床和影像学特点[J]. 中国临床医学影像杂志, 2017, 28(8):542-545.
[20] Ozelame RV, Shroff M, Wood B, et al. Basal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatrophy[J]. Pediatr Radiol, 2006, 36(4):325330.
[21] Wong ST, Yuen SC, Fong D. Pathophysiological mechanism of ipsilateral cerebral and brainstem hemiatrophy in basal ganglia germ cell tumors: case report[J]. Child’s Nerv Syst, 2009, 25(6):693699.
[22] Murray MJ, Bartels U, Nishikawa R, et al. Consensus on the management of intracranial germ cell tumors[J]. Lancet Oncol, 2015, 16(9):470-477.
[23] 黄立敏, 雷竹, 曹雪, 等. 低剂量诊断性放疗联合化疗在诊治颅内生殖细胞肿瘤中的价值[J]. 中国癌症杂志, 2018, 28(4):270-275.
[24] Höftberger R, Lassmann H. Inflammatory demyelinating diseases of the central nervous system[J]. Handb Clin Neurol, 2017, 145:263-283.
doi: B978-0-12-802395-2.00019-5 pmid: 28987175
[25] Fu W, Ju Y, Zhang S, et al. Pediatric basal ganglia region tumors: clinical and radiologic features correlated with histopathologic fin-dings[J]. World Neurosurg, 2017, 103:504-516.
doi: 10.1016/j.wneu.2017.04.004
[26] 阮胜, 魏根霞. 基底节区胶质瘤与生殖细胞肿瘤的 MRI 诊断和鉴别诊断[J]. 功能与分子医学影像学杂志, 2016, 5(2):926-929.
[1] ZHANG Fan,CHEN Qu,HAO Yi-chang,YAN Ye,LIU Cheng,HUANG Yi,MA Lu-lin. Relationship between recovery of urinary continence after laparoscopic radical prostatectomy and preoperative/postoperative membranous urethral length [J]. Journal of Peking University (Health Sciences), 2022, 54(2): 299-303.
[2] Yi-fan WU,Xiao-yuan ZHANG,Shuang REN,Ying-xiang YU,Cui-qing CHANG. Measurement and evaluation of the quadriceps muscle mass in young men based on magnetic resonance imaging [J]. Journal of Peking University (Health Sciences), 2021, 53(5): 843-849.
[3] LI Peng,PIAO Mu-zi,HU Hong-cheng,WANG Yong,ZHAO Yi-jiao,SHEN Xiao-jing. Radiography study on osteotome sinus floor elevation with placed implant simultaneously with no graft augmentation [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 95-101.
[4] Hui SHENG,Lei LIANG,Tong-liang ZHOU,Yan-xing JIA,Tong WANG,Lan YUAN,Hong-bin HAN. Improved synthesis process of optical-magnetic bimodal probe of Gd-[4,7-Bis-carboxymethyl-10-(2-fluoresceinthioureaethyl)-1,4,7,10-tetraaza-cyclododec-1-yl]-acetic acid complexes [J]. Journal of Peking University (Health Sciences), 2020, 52(5): 959-963.
[5] Shi-ming ZHAO,Tie-jun YANG,Chun-miao XU,Xiao-feng GUO,Yong-kang MA,Xue-jun CHEN,Xiang LI,Chao-hong HE. Bladder cancer local staging about muscle invasion: 3.0T MRI performance following transurethral resection [J]. Journal of Peking University (Health Sciences), 2020, 52(4): 701-704.
[6] Yu SONG,Hong-bin HAN,Jun YANG,Ai-bo WANG,Qing-yuan HE,Yuan-yuan LI,Guo-mei ZHAO,Ya-juan GAO,Rui WANG,Yi-xing HAN,Ai-lian LIU,Qing-wei SONG. Effect of convection enhanced delivery on the microstructure of brain extracellular space in aged rats [J]. Journal of Peking University (Health Sciences), 2020, 52(2): 362-367.
[7] Jing-yun WU,Yue MI,Shui LIU,Lin YAO,Qi TANG,Zhi-song HE,Xiao-ying WANG. Evaluating inferior vena cava wall invasion in renal cell carcinoma tumor thrombus with MRI [J]. Journal of Peking University(Health Sciences), 2019, 51(4): 673-677.
[8] Li XU,Ming-jie HU,Yu-yu LI,Hong-dang QU,Wei-dong QIAN,Xiao-lin LIU. Superficial siderosis of the central nervous system caused by myxopapillary ependymoma of conus medullaris and cauda equine: a case report and literature review [J]. Journal of Peking University(Health Sciences), 2019, 51(4): 769-774.
[9] Hong-bin HAN. Discovery of a new division system in brain and the regionalized drainage route of brain interstitial fluid [J]. Journal of Peking University(Health Sciences), 2019, 51(3): 397-401.
[10] Wei WANG,Jin HOU,Wen-qiang HUANG. Temporary acceleration of interstitial fluid drainage in excited brain region induced by movement [J]. Journal of Peking University(Health Sciences), 2019, 51(2): 206-209.
[11] Jun-ying CHANG,Mei ZHENG,Ying LIU,Rui LIU,Jing-feng ZHANG,Xiao-li DENG. Multidisciplinary classification of magnetic resonance imaging features of neuropsychiatric lupus [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1009-1013.
[12] WANG Huan, QIN Xiao-ya, LI Zi-yuan, ZHENG Zhuo-zhao, FAN Tian-yuan. Preparation and characterization of citric acid-modified superparamagnetic iron oxide nanoparticles [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 340-346.
[13] LI Yun-qian1,2,3, SHENG Hui, LIANG Lei, ZHAO Yue, LI Huai-ye, BAI Ning, WAN Tong, YUAN Lan, HAN Hong-bin. Application of anoptomagnetic probe Gd-DO3A-EA-FITC in imaging and analyzing the brain interstitial space [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 221-225.
[14] LIU E, ZHANG Yi-xuan, SUN Lin-lin,TENG Ze, WANG Ai-bo, HAN Hong-bin, YAN Jun-hao. Role of aquaporin-4 in the change of interstitial fluid drainage in Alzheimer’s disease [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 203-206.
[15] LIU Xiao-dong1, CUI Li-gang, XU Yan, SUN Yang, HAO Yun-xia, SONG Lin. Application of ultrasound for evaluation of anterosuperior acetabular labral tear [J]. Journal of Peking University(Health Sciences), 2017, 49(6): 1014-1018.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 125 -128 .
[2] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 158 -161 .
[3] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 217 -220 .
[4] . [J]. Journal of Peking University(Health Sciences), 2009, 41(5): 599 -601 .
[5] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 304 -309 .
[6] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 319 -322 .
[7] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 337 -340 .
[8] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 365 -368 .
[9] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 381 -384 .
[10] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 385 -387 .
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd