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Germinoma
Anne G. Osborn, MD, FACR; Majda M. Thurnher, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Intracranial germ cell tumor (iGCT)
            • Synonyms

              • Dysgerminoma, extragonadal seminoma
            • Definitions

              • iGCTs are intracranial homologue of gonadal germinomas (ovarian dysgerminoma, testicular seminoma)

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Takami H et al: Human chorionic gonadotropin is expressed virtually in all intracranial germ cell tumors. J Neurooncol. 124(1):23-32, 2015
                                            2. Vasiljevic A et al: Histopathology of pineal germ cell tumors. Neurochirurgie. 61(2-3):130-7, 2015
                                            3. Côté M et al: Normal dimensions of the posterior pituitary bright spot on magnetic resonance imaging. J Neurosurg. 120(2):357-62, 2014
                                            4. Fukushima S et al: Mutually exclusive mutations of KIT and RAS are associated with KIT mRNA expression and chromosomal instability in primary intracranial pure germinomas. Acta Neuropathol. 127(6):911-25, 2014
                                            5. Terashima K et al: Genome-wide analysis of DNA copy number alterations and loss of heterozygosity in intracranial germ cell tumors. Pediatr Blood Cancer. 61(4):593-600, 2014
                                            6. Jinguji S et al: Factors affecting functional outcomes in long-term survivors of intracranial germinomas: a 20-year experience in a single institution. J Neurosurg Pediatr. 11(4):454-63, 2013
                                            7. Khan AA et al: An unusual anatomic and geographic location of primary germinoma of the fourth ventricle. J Clin Neurosci. 20(11):1620-2, 2013
                                            8. Sethi RV et al: Delayed diagnosis in children with intracranial germ cell tumors. J Pediatr. 163(5):1448-53, 2013
                                            9. Park DeWitt J et al: Primary intracranial germ cell tumor originating from septum pellucidum that mimics central neurocytoma. J Clin Oncol. 30(27):e274-7, 2012
                                            10. Lee J et al: Atypical basal ganglia germinoma presenting as cerebral hemiatrophy: diagnosis and follow-up with 11C-methionine positron emission tomography. Childs Nerv Syst. 25(1):29-37, 2009
                                            11. Yang DT et al: Primary pontomedullary germinoma in a 12 year old boy. J Clin Neurosci. 16(2):321-5, 2009
                                            12. Guerrero-Vázquez S et al: [Simultaneous suprasellar and pineal germinoma: a case report] Rev Neurol. 46(7):411-5, 2008
                                            13. Kawai N et al: Targeting optimal biopsy location in basal ganglia germinoma using (11)C-methionine positron emission tomography. Surg Neurol. 70(4):408-13; discussion 413, 2008
                                            14. Rossi A et al: Bilateral germinoma of the basal ganglia. Pediatr Blood Cancer. 50(1):177-9, 2008
                                            15. Villani A et al: Inherent diagnostic and treatment challenges in germinoma of the basal ganglia: a case report and review of the literature. J Neurooncol. 88(3):309-14, 2008
                                            16. Ghirardello S et al: The diagnosis of children with central diabetes insipidus. J Pediatr Endocrinol Metab. 20(3):359-75, 2007
                                            17. Sartori S et al: Germinoma with synchronous involvement of midline and off-midline structures associated with progressive hemiparesis and hemiatrophy in a young adult. Childs Nerv Syst. 23(11):1341-5, 2007
                                            18. Lee L et al: Germinoma with synchronous lesions in the pineal and suprasellar regions. Childs Nerv Syst. 22(12):1513-8, 2006
                                            19. Ueno T et al: Spectrum of germ cell tumors: from head to toe. Radiographics. 24(2):387-404, 2004
                                            20. Knierim DS et al: Pineal tumors and associated lesions: the effect of ethnicity on tumor type and treatment. Pediatr Neurosurg. 38(6):307-23, 2003
                                            21. Liang L et al: MRI of intracranial germ-cell tumours. Neuroradiology. 44(5):382-8, 2002
                                            22. Abe T et al: Usefulness of gallium-67 scintigraphy in neurohypophyseal germinoma. Acta Neurochir (Wien). 142(6):655-60, 2000
                                            23. Gömöri E et al: Cytogenetic profile of primary pituitary germinoma. J Neurooncol. 50(3):251-5, 2000
                                            24. Sano K: Pathogenesis of intracranial germ cell tumors reconsidered. J Neurosurg. 90(2):258-64, 1999
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Intracranial germ cell tumor (iGCT)
                                                      • Synonyms

                                                        • Dysgerminoma, extragonadal seminoma
                                                      • Definitions

                                                        • iGCTs are intracranial homologue of gonadal germinomas (ovarian dysgerminoma, testicular seminoma)

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Takami H et al: Human chorionic gonadotropin is expressed virtually in all intracranial germ cell tumors. J Neurooncol. 124(1):23-32, 2015
                                                                                      2. Vasiljevic A et al: Histopathology of pineal germ cell tumors. Neurochirurgie. 61(2-3):130-7, 2015
                                                                                      3. Côté M et al: Normal dimensions of the posterior pituitary bright spot on magnetic resonance imaging. J Neurosurg. 120(2):357-62, 2014
                                                                                      4. Fukushima S et al: Mutually exclusive mutations of KIT and RAS are associated with KIT mRNA expression and chromosomal instability in primary intracranial pure germinomas. Acta Neuropathol. 127(6):911-25, 2014
                                                                                      5. Terashima K et al: Genome-wide analysis of DNA copy number alterations and loss of heterozygosity in intracranial germ cell tumors. Pediatr Blood Cancer. 61(4):593-600, 2014
                                                                                      6. Jinguji S et al: Factors affecting functional outcomes in long-term survivors of intracranial germinomas: a 20-year experience in a single institution. J Neurosurg Pediatr. 11(4):454-63, 2013
                                                                                      7. Khan AA et al: An unusual anatomic and geographic location of primary germinoma of the fourth ventricle. J Clin Neurosci. 20(11):1620-2, 2013
                                                                                      8. Sethi RV et al: Delayed diagnosis in children with intracranial germ cell tumors. J Pediatr. 163(5):1448-53, 2013
                                                                                      9. Park DeWitt J et al: Primary intracranial germ cell tumor originating from septum pellucidum that mimics central neurocytoma. J Clin Oncol. 30(27):e274-7, 2012
                                                                                      10. Lee J et al: Atypical basal ganglia germinoma presenting as cerebral hemiatrophy: diagnosis and follow-up with 11C-methionine positron emission tomography. Childs Nerv Syst. 25(1):29-37, 2009
                                                                                      11. Yang DT et al: Primary pontomedullary germinoma in a 12 year old boy. J Clin Neurosci. 16(2):321-5, 2009
                                                                                      12. Guerrero-Vázquez S et al: [Simultaneous suprasellar and pineal germinoma: a case report] Rev Neurol. 46(7):411-5, 2008
                                                                                      13. Kawai N et al: Targeting optimal biopsy location in basal ganglia germinoma using (11)C-methionine positron emission tomography. Surg Neurol. 70(4):408-13; discussion 413, 2008
                                                                                      14. Rossi A et al: Bilateral germinoma of the basal ganglia. Pediatr Blood Cancer. 50(1):177-9, 2008
                                                                                      15. Villani A et al: Inherent diagnostic and treatment challenges in germinoma of the basal ganglia: a case report and review of the literature. J Neurooncol. 88(3):309-14, 2008
                                                                                      16. Ghirardello S et al: The diagnosis of children with central diabetes insipidus. J Pediatr Endocrinol Metab. 20(3):359-75, 2007
                                                                                      17. Sartori S et al: Germinoma with synchronous involvement of midline and off-midline structures associated with progressive hemiparesis and hemiatrophy in a young adult. Childs Nerv Syst. 23(11):1341-5, 2007
                                                                                      18. Lee L et al: Germinoma with synchronous lesions in the pineal and suprasellar regions. Childs Nerv Syst. 22(12):1513-8, 2006
                                                                                      19. Ueno T et al: Spectrum of germ cell tumors: from head to toe. Radiographics. 24(2):387-404, 2004
                                                                                      20. Knierim DS et al: Pineal tumors and associated lesions: the effect of ethnicity on tumor type and treatment. Pediatr Neurosurg. 38(6):307-23, 2003
                                                                                      21. Liang L et al: MRI of intracranial germ-cell tumours. Neuroradiology. 44(5):382-8, 2002
                                                                                      22. Abe T et al: Usefulness of gallium-67 scintigraphy in neurohypophyseal germinoma. Acta Neurochir (Wien). 142(6):655-60, 2000
                                                                                      23. Gömöri E et al: Cytogenetic profile of primary pituitary germinoma. J Neurooncol. 50(3):251-5, 2000
                                                                                      24. Sano K: Pathogenesis of intracranial germ cell tumors reconsidered. J Neurosurg. 90(2):258-64, 1999