Management of hydrocephalus in a pediatric bifocal germinoma

Germinomas represent the most frequent tumour type in the pineal region. However, the synchronous involvement of the suprasellar region, frequently termed bifocal intracranial germinoma (BFG) is quite rare. A literature search identified a further of 48 pediatric cases with a median age of 12.9 year...

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Autores principales:	Ricardo Santos de Oliveira, Rodrigo Inácio Pongeluppi, Elvis Terci Valera
Formato:	article
Lenguaje:	EN
Publicado:	Brazilian Society for Pediatric Neurosurgery 2020
Materias:	hydrocephalus tumor germinoma Pediatrics RJ1-570 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/af0b536340d340bcb2f4f2d0338b2b58
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spelling	oai:doaj.org-article:af0b536340d340bcb2f4f2d0338b2b582021-11-23T21:46:37ZManagement of hydrocephalus in a pediatric bifocal germinoma2675-362610.29327/apn.v2i1(January-April).22https://doaj.org/article/af0b536340d340bcb2f4f2d0338b2b582020-04-01T00:00:00Zhttps://www.archpedneurosurg.com.br/pkp/index.php/sbnped2019/article/view/22https://doaj.org/toc/2675-3626Germinomas represent the most frequent tumour type in the pineal region. However, the synchronous involvement of the suprasellar region, frequently termed bifocal intracranial germinoma (BFG) is quite rare. A literature search identified a further of 48 pediatric cases with a median age of 12.9 years. BFG is known to be highly radiosensitive. We presented a clinical case of pediatric bifocal germinoma. A 14-year-old boy presented with clinical features of progressive headaches since three months associated with vomits. MR showed two distinct lesions in the pineal and suprasellar regions. Neuroaxis spine MR was normal. Tumor markers for germ cell tumors from blood and cerebrospinal fluid were within the normal range. An endoscopic procedure was performed to treat the hydrocephalus (endoscopic third ventriculostomy) and, in the same procedure the suprasellar lesion was biopsied and the histology revealed a germinoma. She received chemotherapy and a focal radiotherapy covering the sites of primary disease and the ventricular system. Three months after the completion of treatment, the patient achieved a complete clinical and radiological response, which was maintained during the 5-years follow-up period. The optimum management of primary intracranial pineal and suprasellar (bifocal) germinomas still remains controversial. The definition as either localized or disseminated disease has major implications on required treatment and its associated late morbidity. Prospective studies with large cooperative groups worldwide and consensus meetings may reduce uncertainties regarding available management options.Ricardo Santos de OliveiraRodrigo Inácio PongeluppiElvis Terci ValeraBrazilian Society for Pediatric NeurosurgeryarticlehydrocephalustumorgerminomaPediatricsRJ1-570SurgeryRD1-811ENArchives of Pediatric Neurosurgery, Vol 2, Iss 1(January-April), Pp 55-55 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	hydrocephalus tumor germinoma Pediatrics RJ1-570 Surgery RD1-811
spellingShingle	hydrocephalus tumor germinoma Pediatrics RJ1-570 Surgery RD1-811 Ricardo Santos de Oliveira Rodrigo Inácio Pongeluppi Elvis Terci Valera Management of hydrocephalus in a pediatric bifocal germinoma
description	Germinomas represent the most frequent tumour type in the pineal region. However, the synchronous involvement of the suprasellar region, frequently termed bifocal intracranial germinoma (BFG) is quite rare. A literature search identified a further of 48 pediatric cases with a median age of 12.9 years. BFG is known to be highly radiosensitive. We presented a clinical case of pediatric bifocal germinoma. A 14-year-old boy presented with clinical features of progressive headaches since three months associated with vomits. MR showed two distinct lesions in the pineal and suprasellar regions. Neuroaxis spine MR was normal. Tumor markers for germ cell tumors from blood and cerebrospinal fluid were within the normal range. An endoscopic procedure was performed to treat the hydrocephalus (endoscopic third ventriculostomy) and, in the same procedure the suprasellar lesion was biopsied and the histology revealed a germinoma. She received chemotherapy and a focal radiotherapy covering the sites of primary disease and the ventricular system. Three months after the completion of treatment, the patient achieved a complete clinical and radiological response, which was maintained during the 5-years follow-up period. The optimum management of primary intracranial pineal and suprasellar (bifocal) germinomas still remains controversial. The definition as either localized or disseminated disease has major implications on required treatment and its associated late morbidity. Prospective studies with large cooperative groups worldwide and consensus meetings may reduce uncertainties regarding available management options.
format	article
author	Ricardo Santos de Oliveira Rodrigo Inácio Pongeluppi Elvis Terci Valera
author_facet	Ricardo Santos de Oliveira Rodrigo Inácio Pongeluppi Elvis Terci Valera
author_sort	Ricardo Santos de Oliveira
title	Management of hydrocephalus in a pediatric bifocal germinoma
title_short	Management of hydrocephalus in a pediatric bifocal germinoma
title_full	Management of hydrocephalus in a pediatric bifocal germinoma
title_fullStr	Management of hydrocephalus in a pediatric bifocal germinoma
title_full_unstemmed	Management of hydrocephalus in a pediatric bifocal germinoma
title_sort	management of hydrocephalus in a pediatric bifocal germinoma
publisher	Brazilian Society for Pediatric Neurosurgery
publishDate	2020
url	https://doaj.org/article/af0b536340d340bcb2f4f2d0338b2b58
work_keys_str_mv	AT ricardosantosdeoliveira managementofhydrocephalusinapediatricbifocalgerminoma AT rodrigoinaciopongeluppi managementofhydrocephalusinapediatricbifocalgerminoma AT elvistercivalera managementofhydrocephalusinapediatricbifocalgerminoma
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Management of hydrocephalus in a pediatric bifocal germinoma

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