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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2013;6(3):211-218
Case Report
Coexistence of intracranial germ cell tumor and craniopharyngioma in an
adolescent: case report and review of the literature
Nikolaos Tsoukalas, Maria Tolia, Ioannis D Kostakis, Nikolaos Pistamaltzian, Dimitrios Tryfonopoulos, Georgios Lypas, Georgios
Koumakis, Vasileios Barbounis, Nikolaos Goutas, Anna Efremidis
2nd Department Medical Oncology, “Saint Savvas” Anticancer Hospital, Athens Greece; Medical School, National and Kapodistrian
University of Athens, Athens Greece
Received January 2, 2013; Accepted February 21, 2013; Epub March 21, 2013; Published March 31, 2013
Abstract: Purpose: We present the case of a patient treated for intracranial germ cell tumor in which elements of craniopharyngioma
were found in the residual tumor mass. Findings: A 17 year old patient presented with a history of secondary amenorrhea. She
deteriorated with headache and left eyelid drop, paresis of the abducent nerve and convergent strabismus (Parinaud syndrome). β-
HCG was 722mIU/ml and pregnancy was excluded. AFP was 6322 ng/ml. Brain CT scan showed a large endosellar tumor to the
hypersellar region. There was left papillary atrophy. MRI confirmed a tumor to dorsum sellae. Primary germ cell intracranial tumor was
diagnosed. Severe clinically evident pituitary failure developed with signs of increased intracranial pressure and brain edema as well
as diabetes insipidus, while AFP increased to 15786,3ng/ml. Urgent treatment with combination chemotherapy including cisplatin
etoposide and bleomycin (ΡEB) was administered for 4 courses. As a result her clinical condition improved and tumor markers
dropped but nevertheless did not become normal. In addition CT scans revealed a remaining endocranial mass and therefore the
patient was subjected to high-dose chemotherapy followed by autologous stem-cell rescue which resulted in complete clinical and
biochemical remission. Due to the persisting mass in the area, it was delivered radiotherapy. Conclusions: The above case is
extremely rare in worldwide literature. Dysgerminoma may coexist with craniopharyngioma which in fact may be part of a germ cell
tumor in the context of dysembryogenesis and benign “teratoma”. (IJCEM1301001).
Keywords: Intracranial, germ cell tumor, craniopharyngioma, dysembryogenesis
Address correspondence to: Dr. Nikolaos Tsoukalas, Medical Oncologist, Consultant at “Saint Savvas” Anticancer Hospital,
Gennimata N. 10-12 Ampelokipi 11524, Athens Greece. Tel: +30 6977366056; E-mail: tsoukn@yahoo.gr
Case Report
Coexistence of intracranial germ cell tumor and craniopharyngioma in an
adolescent: case report and review of the literature
Nikolaos Tsoukalas, Maria Tolia, Ioannis D Kostakis, Nikolaos Pistamaltzian, Dimitrios Tryfonopoulos, Georgios Lypas, Georgios
Koumakis, Vasileios Barbounis, Nikolaos Goutas, Anna Efremidis
2nd Department Medical Oncology, “Saint Savvas” Anticancer Hospital, Athens Greece; Medical School, National and Kapodistrian
University of Athens, Athens Greece
Received January 2, 2013; Accepted February 21, 2013; Epub March 21, 2013; Published March 31, 2013
Abstract: Purpose: We present the case of a patient treated for intracranial germ cell tumor in which elements of craniopharyngioma
were found in the residual tumor mass. Findings: A 17 year old patient presented with a history of secondary amenorrhea. She
deteriorated with headache and left eyelid drop, paresis of the abducent nerve and convergent strabismus (Parinaud syndrome). β-
HCG was 722mIU/ml and pregnancy was excluded. AFP was 6322 ng/ml. Brain CT scan showed a large endosellar tumor to the
hypersellar region. There was left papillary atrophy. MRI confirmed a tumor to dorsum sellae. Primary germ cell intracranial tumor was
diagnosed. Severe clinically evident pituitary failure developed with signs of increased intracranial pressure and brain edema as well
as diabetes insipidus, while AFP increased to 15786,3ng/ml. Urgent treatment with combination chemotherapy including cisplatin
etoposide and bleomycin (ΡEB) was administered for 4 courses. As a result her clinical condition improved and tumor markers
dropped but nevertheless did not become normal. In addition CT scans revealed a remaining endocranial mass and therefore the
patient was subjected to high-dose chemotherapy followed by autologous stem-cell rescue which resulted in complete clinical and
biochemical remission. Due to the persisting mass in the area, it was delivered radiotherapy. Conclusions: The above case is
extremely rare in worldwide literature. Dysgerminoma may coexist with craniopharyngioma which in fact may be part of a germ cell
tumor in the context of dysembryogenesis and benign “teratoma”. (IJCEM1301001).
Keywords: Intracranial, germ cell tumor, craniopharyngioma, dysembryogenesis
Address correspondence to: Dr. Nikolaos Tsoukalas, Medical Oncologist, Consultant at “Saint Savvas” Anticancer Hospital,
Gennimata N. 10-12 Ampelokipi 11524, Athens Greece. Tel: +30 6977366056; E-mail: tsoukn@yahoo.gr
