Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group

Mohamed Reda; Mohamed Elbeltagy; Mohamed Kamal; Mahmoud Hammad

doi:doi:10.11648/j.crj.20190702.16

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Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group

Mohamed Reda, Mohamed Elbeltagy, Mohamed Kamal, Mahmoud Hammad

Published in Cancer Research Journal (Volume 7, Issue 2)

Received: 14 May 2019 Accepted: 12 June 2019 Published: 24 June 2019

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Abstract

Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases of ICGCTs easier and safer. Material and methods: Seventeen patients with intracranial germ cell tumors operated upon between 2008 to 2012 at the Children's Cancer Hospital Egypt, were retrospectively reviewed and analyzed regarding the surgical decision, clinical outcome and surgical complications. Results: There were 9 cases of germinoma (53%), and 8 cases of non-germinomatous germ cell tumors (47%). Nine cases were in the pineal region, six in the suprasellar, and two in the thalamic region. Ten cases were operated upon initially by open surgery and frozen section with subtotal resection and seven cases were biopsied either endoscopically (3 cases) or by frameless guided stereotaxic (4 cases). Accurate pathology was achieved in all biopsied cases without major complications. In the germinoma group, the 4-year overall survival and progression free survival rate were 75% for both at a median follow up period of 26 (range 1 -50) months. For the non-germinomatous germ cell tumors group, the 4-year OS and PFS rates were 36.5% and 31.2% at a median follow up period of 11 (range 2-54) months, respectively. Conclusion: In cases of intracranial germ cell tumors with negative tumor markers the role of surgery is important in the establishment of proper histopathological diagnosis. However, in Non Germinomatous Germ Cell Tumors, further investigations should be done regarding the extent of resection owing to the poor long-term outcome.

Published in	Cancer Research Journal (Volume 7, Issue 2)
DOI	10.11648/j.crj.20190702.16
Page(s)	66-72
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Intracranial Germ Cell Tumors, Pediatric, Endoscopic Biopsy, Stereotactic Biopsy

References

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APA Style

Mohamed Reda, Mohamed Elbeltagy, Mohamed Kamal, Mahmoud Hammad. (2019). Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group. Cancer Research Journal, 7(2), 66-72. https://doi.org/10.11648/j.crj.20190702.16

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ACS Style

Mohamed Reda; Mohamed Elbeltagy; Mohamed Kamal; Mahmoud Hammad. Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group. Cancer Res. J. 2019, 7(2), 66-72. doi: 10.11648/j.crj.20190702.16

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AMA Style

Mohamed Reda, Mohamed Elbeltagy, Mohamed Kamal, Mahmoud Hammad. Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group. Cancer Res J. 2019;7(2):66-72. doi: 10.11648/j.crj.20190702.16

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@article{10.11648/j.crj.20190702.16,
  author = {Mohamed Reda and Mohamed Elbeltagy and Mohamed Kamal and Mahmoud Hammad},
  title = {Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group},
  journal = {Cancer Research Journal},
  volume = {7},
  number = {2},
  pages = {66-72},
  doi = {10.11648/j.crj.20190702.16},
  url = {https://doi.org/10.11648/j.crj.20190702.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20190702.16},
  abstract = {Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases of ICGCTs easier and safer. Material and methods: Seventeen patients with intracranial germ cell tumors operated upon between 2008 to 2012 at the Children's Cancer Hospital Egypt, were retrospectively reviewed and analyzed regarding the surgical decision, clinical outcome and surgical complications. Results: There were 9 cases of germinoma (53%), and 8 cases of non-germinomatous germ cell tumors (47%). Nine cases were in the pineal region, six in the suprasellar, and two in the thalamic region. Ten cases were operated upon initially by open surgery and frozen section with subtotal resection and seven cases were biopsied either endoscopically (3 cases) or by frameless guided stereotaxic (4 cases). Accurate pathology was achieved in all biopsied cases without major complications. In the germinoma group, the 4-year overall survival and progression free survival rate were 75% for both at a median follow up period of 26 (range 1 -50) months. For the non-germinomatous germ cell tumors group, the 4-year OS and PFS rates were 36.5% and 31.2% at a median follow up period of 11 (range 2-54) months, respectively. Conclusion: In cases of intracranial germ cell tumors with negative tumor markers the role of surgery is important in the establishment of proper histopathological diagnosis. However, in Non Germinomatous Germ Cell Tumors, further investigations should be done regarding the extent of resection owing to the poor long-term outcome.},
 year = {2019}
}

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TY  - JOUR
T1  - Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group
AU  - Mohamed Reda
AU  - Mohamed Elbeltagy
AU  - Mohamed Kamal
AU  - Mahmoud Hammad
Y1  - 2019/06/24
PY  - 2019
N1  - https://doi.org/10.11648/j.crj.20190702.16
DO  - 10.11648/j.crj.20190702.16
T2  - Cancer Research Journal
JF  - Cancer Research Journal
JO  - Cancer Research Journal
SP  - 66
EP  - 72
PB  - Science Publishing Group
SN  - 2330-8214
UR  - https://doi.org/10.11648/j.crj.20190702.16
AB  - Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases of ICGCTs easier and safer. Material and methods: Seventeen patients with intracranial germ cell tumors operated upon between 2008 to 2012 at the Children's Cancer Hospital Egypt, were retrospectively reviewed and analyzed regarding the surgical decision, clinical outcome and surgical complications. Results: There were 9 cases of germinoma (53%), and 8 cases of non-germinomatous germ cell tumors (47%). Nine cases were in the pineal region, six in the suprasellar, and two in the thalamic region. Ten cases were operated upon initially by open surgery and frozen section with subtotal resection and seven cases were biopsied either endoscopically (3 cases) or by frameless guided stereotaxic (4 cases). Accurate pathology was achieved in all biopsied cases without major complications. In the germinoma group, the 4-year overall survival and progression free survival rate were 75% for both at a median follow up period of 26 (range 1 -50) months. For the non-germinomatous germ cell tumors group, the 4-year OS and PFS rates were 36.5% and 31.2% at a median follow up period of 11 (range 2-54) months, respectively. Conclusion: In cases of intracranial germ cell tumors with negative tumor markers the role of surgery is important in the establishment of proper histopathological diagnosis. However, in Non Germinomatous Germ Cell Tumors, further investigations should be done regarding the extent of resection owing to the poor long-term outcome.
VL  - 7
IS  - 2
ER  -

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Author Information

Mohamed Reda

Department of Neurosurgery, Kasralainy Medical School, Cairo University and Children's Cancer Hospital Egypt, Cairo, Egypt
Mohamed Elbeltagy

Department of Neurosurgery, Kasralainy Medical School, Cairo University and Children's Cancer Hospital Egypt, Cairo, Egypt
Mohamed Kamal

Department of Research Children's Cancer Hospital Egypt, Cairo, Egypt
Mahmoud Hammad

Department of Pediatric Oncology, National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt, Cairo, Egypt

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Mohamed Reda, Mohamed Elbeltagy, Mohamed Kamal, Mahmoud Hammad. (2019). Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group. Cancer Research Journal, 7(2), 66-72. https://doi.org/10.11648/j.crj.20190702.16

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ACS Style

Mohamed Reda; Mohamed Elbeltagy; Mohamed Kamal; Mahmoud Hammad. Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group. Cancer Res. J. 2019, 7(2), 66-72. doi: 10.11648/j.crj.20190702.16

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AMA Style

Mohamed Reda, Mohamed Elbeltagy, Mohamed Kamal, Mahmoud Hammad. Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group. Cancer Res J. 2019;7(2):66-72. doi: 10.11648/j.crj.20190702.16

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@article{10.11648/j.crj.20190702.16,
  author = {Mohamed Reda and Mohamed Elbeltagy and Mohamed Kamal and Mahmoud Hammad},
  title = {Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group},
  journal = {Cancer Research Journal},
  volume = {7},
  number = {2},
  pages = {66-72},
  doi = {10.11648/j.crj.20190702.16},
  url = {https://doi.org/10.11648/j.crj.20190702.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20190702.16},
  abstract = {Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases of ICGCTs easier and safer. Material and methods: Seventeen patients with intracranial germ cell tumors operated upon between 2008 to 2012 at the Children's Cancer Hospital Egypt, were retrospectively reviewed and analyzed regarding the surgical decision, clinical outcome and surgical complications. Results: There were 9 cases of germinoma (53%), and 8 cases of non-germinomatous germ cell tumors (47%). Nine cases were in the pineal region, six in the suprasellar, and two in the thalamic region. Ten cases were operated upon initially by open surgery and frozen section with subtotal resection and seven cases were biopsied either endoscopically (3 cases) or by frameless guided stereotaxic (4 cases). Accurate pathology was achieved in all biopsied cases without major complications. In the germinoma group, the 4-year overall survival and progression free survival rate were 75% for both at a median follow up period of 26 (range 1 -50) months. For the non-germinomatous germ cell tumors group, the 4-year OS and PFS rates were 36.5% and 31.2% at a median follow up period of 11 (range 2-54) months, respectively. Conclusion: In cases of intracranial germ cell tumors with negative tumor markers the role of surgery is important in the establishment of proper histopathological diagnosis. However, in Non Germinomatous Germ Cell Tumors, further investigations should be done regarding the extent of resection owing to the poor long-term outcome.},
 year = {2019}
}

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TY  - JOUR
T1  - Surgical Role in Management of Intracranial Germ Cell Tumors in Pediatric Age Group
AU  - Mohamed Reda
AU  - Mohamed Elbeltagy
AU  - Mohamed Kamal
AU  - Mahmoud Hammad
Y1  - 2019/06/24
PY  - 2019
N1  - https://doi.org/10.11648/j.crj.20190702.16
DO  - 10.11648/j.crj.20190702.16
T2  - Cancer Research Journal
JF  - Cancer Research Journal
JO  - Cancer Research Journal
SP  - 66
EP  - 72
PB  - Science Publishing Group
SN  - 2330-8214
UR  - https://doi.org/10.11648/j.crj.20190702.16
AB  - Introduction: Primary intracranial germ cell tumors (ICGCTs) are rare, histologically diverse, and diagnostically challenging tumors that are usually localized in the pineal and suprasellar regions of the brain. Advanced neurosurgical techniques such as neuroendoscopy and frameless stereotactic biopsy have made diagnosis of newly discovered cases of ICGCTs easier and safer. Material and methods: Seventeen patients with intracranial germ cell tumors operated upon between 2008 to 2012 at the Children's Cancer Hospital Egypt, were retrospectively reviewed and analyzed regarding the surgical decision, clinical outcome and surgical complications. Results: There were 9 cases of germinoma (53%), and 8 cases of non-germinomatous germ cell tumors (47%). Nine cases were in the pineal region, six in the suprasellar, and two in the thalamic region. Ten cases were operated upon initially by open surgery and frozen section with subtotal resection and seven cases were biopsied either endoscopically (3 cases) or by frameless guided stereotaxic (4 cases). Accurate pathology was achieved in all biopsied cases without major complications. In the germinoma group, the 4-year overall survival and progression free survival rate were 75% for both at a median follow up period of 26 (range 1 -50) months. For the non-germinomatous germ cell tumors group, the 4-year OS and PFS rates were 36.5% and 31.2% at a median follow up period of 11 (range 2-54) months, respectively. Conclusion: In cases of intracranial germ cell tumors with negative tumor markers the role of surgery is important in the establishment of proper histopathological diagnosis. However, in Non Germinomatous Germ Cell Tumors, further investigations should be done regarding the extent of resection owing to the poor long-term outcome.
VL  - 7
IS  - 2
ER  -

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