Introduction: Intratumoral calcification is a feature that is more often observed in pineal parenchymal tumour than germinoma. We describe a 13-year-old male with pineal region germinoma demonstrating extensive intratumoral calcification. Case report: He presented with worsening headache that was associated with fatigue, nausea and vomiting. Radiologic examination revealed a multilobular mass in the pineal region with internal calcifications. Biopsy showed a pure germinoma with unusually extensive calcification. Discussion: Although a diagnosis may be suggested with a careful evaluation of imaging, there is no pathognomonic pattern. Thus, histologic verification is necessary for most pineal region masses.
Germinoma

A case of ectopic pinealoma in the region of the sellar trucica, which not enlarged reaiologically, so-called the intrasellar germinoma is described with its clinical manifestions, roentgenographic pictures, pathological findings and therapeutic points of view.
Germinoma ; Pinealoma

A case of ectopic pinealoma in the region of the sellar trucica, which not enlarged reaiologically, so-called the intrasellar germinoma is described with its clinical manifestions, roentgenographic pictures, pathological findings and therapeutic points of view.
Germinoma ; Pinealoma

No abstract available.
Germinoma* ; Radiotherapy*

Recently we experienced stereotaxic endoscopic biopsy and resection of intracranial tumors using the Brown-Robert-Wells system. Surgical exploration was undertaken under the local anesthesia:1 germinoma in pineal region, 1 arachnoid cyst in basal cistern. The method is described, and the its potential clinical applications is discussed.
Arachnoid ; Biopsy ; Endoscopy* ; Germinoma

The diagnosis and treatment of pineal tumor has captivated the interest of neurosurgeons for decades. Reports indicated that the majority of these tumors were malignant and thereby couild not be surgically removed and decompressed without high mortality and morbidity. And the pineal tumor especially germinoma is one of the mosdt radiosensitive intracranial tumors. Therefore a regime of radiotherapy combined with ventricular shunting, to relieve hydrocephalus, was advocated. In addition, with development of C-T we make the diagnosis easily and assess the result of treatment. We report a pineal tumor which was treated completely by irradiation following ventriculo-atrial shunt.
Diagnosis ; Germinoma ; Hydrocephalus ; Mortality ; Pinealoma* ; Radiotherapy

Brain Neoplasms ; Germinoma ; Humans ; Pineal Gland

Although extra-axial hematoma is a well known complication in ventricular shunting, epidural hematomas(EDH) are not common in this setting. This is the report of an unusual case of acute EDH in a patient with hydrocephalus caused by pineal germinoma treated by ventriculoperitoneal(V-P) shunt and radiotherapy. The formation of acute EDH has been rarely reported as a complication of V-P shunt. We would like to share our experience with a case of acute EDH after 4 months of V-P shunt and a review of the literature is also included.
Germinoma ; Hematoma* ; Humans ; Hydrocephalus ; Radiotherapy ; Ventriculoperitoneal Shunt*

OBJECTIVETo study the immunohistochemical expression of OCT4, CD117 and CD30 in germ cell tumors and to assess their diagnostic value.

METHODSImmunohistochemical study for OCT4 was performed on formalin-fixed, paraffin-embedded tissues of 63 cases of germ cell tumors, including seminoma (21), dysgerminoma (7), germinoma (8), embryonal carcinoma (8), yolk sac tumor (6), mature teratoma (10) and immature teratoma (3), as well as 25 cases of non-germ cell tumors, including granulosa cell tumor (8), clear cell adenocarcinoma (4), Leydig's cell tumor (5), diffuse large B-cell lymphoma (4) and malignant melanoma (4). Besides, the expression of CD117 and CD30 in all germ cell tumors was studied.

RESULTSAll cases of seminoma and germinoma, 6/7 cases of dysgerminoma and 7/8 cases of embryonal carcinoma were positive for OCT4, with strong nuclear staining. All other germ cell tumors and non-germ cell tumors were negative for OCT4, except for 1 case of yolk sac tumor and 1 case of clear cell adenocarcinoma which showed weak staining. Positive membranous expression of CD117 was demonstrated in 19/21(90.5%) seminoma, 5/7 dysgerminoma and 7/8 germinoma. Focal weak membranous staining was also noted in 1 case of yolk sac tumor. The melanocytes in teratoma were also positive for CD117. All cases of embryonal carcinoma were negative. On the other hand, positive membranous expression of CD30 were demonstrated in 6/8 embryonal carcinoma. One case of germinoma and 1 case of yolk sac tumor showed weak cytoplasmic positivity. All cases of seminoma and dysgerminoma, 7/8 germinoma and all cases of teratoma were negative for CD30.

CONCLUSIONSOCT4 is a sensitive and relatively specific marker for diagnosing seminoma, dysgerminoma, germinoma and embryonal carcinoma. CD117 and CD30 immunostains, when used in combination, represent valuable tools for distinguishing embryonal carcinoma and seminoma, dysgerminoma, germinoma.

Carcinoma, Embryonal ; metabolism ; pathology ; Diagnosis, Differential ; Dysgerminoma ; metabolism ; pathology ; Endodermal Sinus Tumor ; metabolism ; pathology ; Female ; Germinoma ; metabolism ; pathology ; Humans ; Ki-1 Antigen ; metabolism ; Male ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; Octamer Transcription Factor-3 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-kit ; metabolism ; Seminoma ; metabolism ; pathology ; Teratoma ; metabolism ; pathology ; Testicular Neoplasms ; metabolism ; pathology

The authors think that the more desirable treatment for pineal region tumors is definitive surgery with a histological diagnosis and that a conservative approach consisting of shunting and radiation therapy no longer seems to be appropriate. We report the result of a retrospective review of the presentation, treatment, and outcome of the seventeen patients treated between June, 1989 and June, 1994. Nine patients were males and eight patients were females, and the age ranged from 13 to 51 years(mean age about 32 years old). Histological verification was available in fourteen tumors;six by an occipital transtentorial approach and five by an infratentorial supracerebellar approach and two by a stereotaxic biopsy and one by a frontotemporal craniotomy for ectopic germinoma. Germinomas were the most common type. Three of the seventeen patients died of tumor progression. Because the great variety of tumor found in the pineal region must be treated in different ways and because improved microsurgical and stereotaxic surgical techniques have made mortality and morbidity rates acceptably low, a biopsy diagnosis should be obtained.
Biopsy ; Craniotomy ; Diagnosis ; Female ; Germinoma ; Humans ; Male ; Mortality ; Retrospective Studies