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Malignant transformation of germinoma 14 years after onset: Favorable efficacy of oral etoposide
Author(s) -
Fukuoka Kohei,
Yanagisawa Takaaki,
Suzuki Tomonari,
Shirahata Mitsuaki,
Adachi Junichi,
Mishima Kazuhiko,
Fujimaki Takamitsu,
Matsutani Masao,
Nishikawa Ryo
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12559
Subject(s) - medicine , etoposide , germinoma , germ cell tumors , magnetic resonance imaging , chemotherapy , radiation therapy , lesion , pathology , radiology
We report the case of a 19‐year‐old woman with a highly malignant intracranial germ cell tumor ( GCT ) that developed 14 years after treatment for neurohypophyseal germinoma. Magnetic resonance imaging ( MRI ) showed a large neurohypophyseal mass and a synchronous lesion in the pineal region. Plasma α‐fetoprotein was elevated to 3038 ng/mL. Although the tumor shrank and tumor marker levels normalized after chemotherapy and craniospinal irradiation, treatment was switched to oral etoposide for the residual tumor because of adverse events. MRI after oral etoposide introduction showed additional tumor shrinkage for 27 months after the onset of the second tumor. To the best of our knowledge, this is the longest interval between germinoma onset and the development of highly malignant recurrent GCT to be reported in the E nglish‐language literature. Oral etoposide prevented regrowth of the GCT , which has a poor prognosis, and decreased the size of the residual tumor.