Third ventricle teratoma with malignant transformation
https://doi.org/10.17650/1683-3295-2024-26-3-79-88
Abstract
Intracranial germ cell tumors(GCTs) are rare and heterogeneous group of primary brain tumors, mainly affecting pediatric population and young adults. The current understanding of the etiology of intracranial GCTs and their optimal management strategies remain controversial. Treatment plans differ depending on the subtype GCT and may vary among physicians and institutions. Central nervous system non-germinomatous germ cell tumor (NGGCT) usually requires surgical resection with histological verification, chemotherapy, and radiation. The extent of surgical resection is an important prognostic factor alongside the etiology and genetics of NGGCT. This article presents a rare clinical case of a rapidly growing teratoma located in the posterior part of third ventricle of a 17-year-old male presenting with symptoms of intracranial hypertension. Surgical total resection was preceded by endoscopic third ventriculostomy. Immunohistochemistry revealed the presence of embryonal carcinoma and immature teratoma cells turning the tumor into mixed type NGGCT with unfavorable prognosis. Despite the complete resection of the tumor and the timely initiation of adjuvant therapy, a rapid progression of the disease with subsequent unfavorable outcome was observed 3.6 months after the surgical treatment.
About the Authors
Yu. R. Akchurina
Russian University of Medicine, Ministry of Health of Russia
Russian Federation
Russian Federation
Bld. 1, 20 Delegatskaya St., Moscow 127473
V. A. Gorozhanin
Medical Center “UNIKLINIK”
Russian Federation
Russian Federation
5 Muranovskaya St., Moscow 127543
T. A. Shatokhin
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia;
Research Center of Neurology;
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
1 Ostrovityanova St., Moscow 117997;
80 Volokolamskoye Shosse, Moscow 125367;
3 Bolshaya Sukharevskaya Sq., Moscow 129090
V. A. Lukyanchikov
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia;
Research Center of Neurology;
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
1 Ostrovityanova St., Moscow 117997;
80 Volokolamskoye Shosse, Moscow 125367;
3 Bolshaya Sukharevskaya Sq., Moscow 129090
References
1. Murray M.J., Bartels U., Nishikawa R. et al. Consensus on the management of intracranial germ-cell tumours. Lancet Oncol 2015;16(9):e470–e7. DOI: 10.1016/S1470-2045(15)00244-2
2. Goodwin T.L., Sainani K., Fisher P.G. Incidence patterns of central nervous system germ cell tumors: a SEER study. J Pediatr Hematol Oncol 2009;31(8):541–4. DOI: 10.1097/MPH.0b013e3181983af5
3. Ostrom Q.T., Cioffi G., Gittleman H. et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012–2016. Neuro Oncol 2019;21(Suppl 5):v1–v100. DOI: 10.1093/neuonc/noz150
4. Matsutani M., Sano K., Takakura K. et al. Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 1997;86(3):446–55. DOI: 10.3171/jns.1997.86.3.0446
5. Louis D.N., Perry A., Wesseling P. et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol 2021;23(8):1231–51. DOI: 10.1093/neuonc/noab106
6. Intracranial germ cell tumors. Ed. by Y. Sawamura, H. Shirato, N. de Tribolet. Springer, Vienna, 1998. DOI: 10.1007/978-3-7091-6821-9
7. Hong K.T., Han J.W., Fuji H. et al. Outcomes of intracranial nongerminomatous germ cell tumors: a retrospective Asian multinational study on treatment strategies and prognostic factors. J Neurooncol 2022;160(1):41–53. DOI: 10.1007/s11060-022-04100-w
8. Fujimaki T. Central nervous system germ cell tumors: classification, clinical features, and treatment with a historical overview. J Child Neurol 2009;24(11):1439–45. DOI: 10.1177/0883073809342127
9. Calaminus G., Bamberg M., Baranzelli M. et al. Intracranial germ cell tumors: a comprehensive update of the European data. Neuropediatrics 1994;25(01):26–32. DOI: 10.1055/s-2008-1071577
10. Kellie S.J., Boyce H., Dunkel I.J. et al. Intensive cisplatin and cyclophosphamide-based chemotherapy without radiotherapy for intracranial germinomas: failure of a primary chemotherapy approach. Pediatr Blood Cancer 2004;43(2):126–33. DOI: 10.1002/pbc.20026
11. Balmaceda C., Finlay J. Current advances in the diagnosis and management of intracranial germ cell tumors. Curr Neurol Neurosci Rep 2004;4(3):253–62. DOI: 10.1007/s11910-004-0046-0
12. Da Silva N.S., Cappellano A.M., Diez B. et al. Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell tumor study. Pediatr Blood Cancer 2010;54(3):377–83. DOI: 10.1002/pbc.22381
13. Murray M.J., Bailey S., Heinemann K. et al. Treatment and outcomes of UK and German patients with relapsed intracranial germ cell tumors following uniform first-line therapy: relapsed intracranial germ cell tumors. Int J Cancer 2017;141(3):621–35. DOI: 10.1002/ijc.30755
14. Yeo K.K., MacDonald S.M. CNS non-germinomatous germ cell tumor (NGGCT): lessons from the recent past. Neuro Oncol 2022;24(11):1962–3. DOI: 10.1093/neuonc/noac119
15. Fangusaro J., Wu S., MacDonald S. et al. GERM-15. A phase 2 trial of response-based radiation therapy for patients with localized central nervous system germ cell tumors (CNS GCT): a Children Oncology Group (COG) study. Neuro Oncol 2018;20(suppl_2):i86. DOI: 10.1093/neuonc/noy059.262
16. Calaminus G., Frappaz D., Kortmann R.D. et al. Outcome of patients with intracranial non-germinomatous germ cell tumors – lessons from the SIOP-CNS-GCT-96 trial. Neuro Oncol 2017;19(12):1661–72. DOI: 10.1093/neuonc/nox122
17. Goldman S., Bouffet E., Fisher P.G. et al. Phase II trial assessing the ability of neoadjuvant chemotherapy with or without secondlook surgery to eliminate measurable disease for nongerminomatous germ cell tumors: a Children’s Oncology Group Study. J Clin Oncol 2015;33(22):2464–71. DOI: 10.1200/JCO.2014.59.5132
18. Curtin S.C., Minino A.M., Anderson R.N. Declines in cancer death rates among children and adolescents in the United States, 1999–2014. NCHS Data Brief 2016;(257):1–8.
19. Fonseca A., Faure-Conter C., Murray M.J. et al. Pattern of treatment failures in patients with central nervous system nongerminomatous germ cell tumors (CNS-NGGCT): a pooled analysis of clinical trials. Neuro Oncol 2022;24(11):1950–61. DOI: 10.1093/neuonc/noac057
20. Woods J.K., Lidov H.G., Ligon K.L. et al. PD-L1 and PD-1 expression in pediatric central nervous system germ cell tumors. Mod Pathol 2022;35(12):1770–4. DOI: 10.1038/s41379-022-01142-3
Review
For citations:
Akchurina Yu.R., Gorozhanin V.A., Shatokhin T.A., Lukyanchikov V.A. Third ventricle teratoma with malignant transformation. Russian journal of neurosurgery. 2024;26(3):79-88. https://doi.org/10.17650/1683-3295-2024-26-3-79-88
Views:
322
Email this article 