Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report
Abstract Background Intracranial germ cell tumors (GCTs) comprise 3%–5% of pediatric primary central nervous system (CNS) tumors in Western countries. Though they are related in embryonic origin to gonadal GCTs, which are considered highly treatable with cisplatin‐based chemotherapy regimens, intrac...
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Cancer Reports |
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| Online Access: | https://doi.org/10.1002/cnr2.1586 |
| _version_ | 1811315898594623488 |
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| author | Jackson Howell Christopher Dandoy Jordan M. Wright Lionel Chow Ayman El‐Sheikh Mukund Dole Ralph E. Vatner Kambiz Kamian |
| author_facet | Jackson Howell Christopher Dandoy Jordan M. Wright Lionel Chow Ayman El‐Sheikh Mukund Dole Ralph E. Vatner Kambiz Kamian |
| author_sort | Jackson Howell |
| collection | DOAJ |
| description | Abstract Background Intracranial germ cell tumors (GCTs) comprise 3%–5% of pediatric primary central nervous system (CNS) tumors in Western countries. Though they are related in embryonic origin to gonadal GCTs, which are considered highly treatable with cisplatin‐based chemotherapy regimens, intracranial GCTs vary in malignant potential and sensitivity to radiation and chemotherapy, generally carrying a worse prognosis. Metastases of intracranial GCTs outside of the CNS are rare, indicate a poor prognosis, and their salvage treatment is not well established. Case A 15‐year‐old boy presented with bifocal (suprasellar and pineal) intracranial nongerminomatous germ cell tumors of mixed origin. The tumors were treated to full response with a multimodal approach of neoadjuvant chemotherapy, surgical resection, and adjuvant craniospinal proton radiation. Nine months following treatment completion, the patient presented with an enlarged cervical lymph node determined on excisional biopsy to be a recurrence of pure germinoma from the primary tumors. Salvage treatment involved high‐dose chemotherapy and autologous stem cell transplantation; however, the patient denied further treatment prior to planned focal radiotherapy. Thirty months post‐treatment, the patient is well with no evidence of recurrence. Conclusion This case demonstrated the successful salvage treatment of an extraneural recurrence of an intracranial GCT using surgical resection and a high‐dose chemotherapy and autologous stem‐cell transplantation regimen, highlighting the unique factors which led to the selection of this regimen. |
| first_indexed | 2024-04-13T11:39:47Z |
| format | Article |
| id | doaj.art-67492de0375e44518123f55adae72dbc |
| institution | Directory Open Access Journal |
| issn | 2573-8348 |
| language | English |
| last_indexed | 2024-04-13T11:39:47Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Reports |
| spelling | doaj.art-67492de0375e44518123f55adae72dbc2022-12-22T02:48:21ZengWileyCancer Reports2573-83482022-08-0158n/an/a10.1002/cnr2.1586Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case reportJackson Howell0Christopher Dandoy1Jordan M. Wright2Lionel Chow3Ayman El‐Sheikh4Mukund Dole5Ralph E. Vatner6Kambiz Kamian7Department of Radiation Oncology University of Cincinnati College of Medicine Cincinnati Ohio USACancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center Cincinnati Ohio USADepartment of Hematology/Oncology Dayton Children's Hospital Dayton Ohio USADepartment of Hematology/Oncology Dayton Children's Hospital Dayton Ohio USADepartment of Hematology/Oncology Dayton Children's Hospital Dayton Ohio USADepartment of Hematology/Oncology Dayton Children's Hospital Dayton Ohio USADepartment of Radiation Oncology University of Cincinnati College of Medicine Cincinnati Ohio USADepartment of Neurosurgery Dayton Children's Hospital Dayton Ohio USAAbstract Background Intracranial germ cell tumors (GCTs) comprise 3%–5% of pediatric primary central nervous system (CNS) tumors in Western countries. Though they are related in embryonic origin to gonadal GCTs, which are considered highly treatable with cisplatin‐based chemotherapy regimens, intracranial GCTs vary in malignant potential and sensitivity to radiation and chemotherapy, generally carrying a worse prognosis. Metastases of intracranial GCTs outside of the CNS are rare, indicate a poor prognosis, and their salvage treatment is not well established. Case A 15‐year‐old boy presented with bifocal (suprasellar and pineal) intracranial nongerminomatous germ cell tumors of mixed origin. The tumors were treated to full response with a multimodal approach of neoadjuvant chemotherapy, surgical resection, and adjuvant craniospinal proton radiation. Nine months following treatment completion, the patient presented with an enlarged cervical lymph node determined on excisional biopsy to be a recurrence of pure germinoma from the primary tumors. Salvage treatment involved high‐dose chemotherapy and autologous stem cell transplantation; however, the patient denied further treatment prior to planned focal radiotherapy. Thirty months post‐treatment, the patient is well with no evidence of recurrence. Conclusion This case demonstrated the successful salvage treatment of an extraneural recurrence of an intracranial GCT using surgical resection and a high‐dose chemotherapy and autologous stem‐cell transplantation regimen, highlighting the unique factors which led to the selection of this regimen.https://doi.org/10.1002/cnr2.1586germ cell tumorsalvage therapyhigh‐dose chemotherapy |
| spellingShingle | Jackson Howell Christopher Dandoy Jordan M. Wright Lionel Chow Ayman El‐Sheikh Mukund Dole Ralph E. Vatner Kambiz Kamian Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report Cancer Reports germ cell tumor salvage therapy high‐dose chemotherapy |
| title | Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report |
| title_full | Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report |
| title_fullStr | Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report |
| title_full_unstemmed | Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report |
| title_short | Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report |
| title_sort | extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient case report |
| topic | germ cell tumor salvage therapy high‐dose chemotherapy |
| url | https://doi.org/10.1002/cnr2.1586 |
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