Chinese Journal Of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (2): 190-195.doi: 10.13418/j.issn.1001-165x.2019.02.015

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Early diagnosis and treatment for basal ganglia germinomas in children

CHENG Long-fei, WU Jia-ming, ZHANG Mao-ying, XIANG Yong-sheng, WANG Xiang-yu, CHEN Ke-en   

  1. Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
  • Received:2018-07-25 Online:2019-03-25 Published:2019-04-29

Abstract:

Objective To study the early diagnosis and treatment for basal ganglia germinomas in children. Methods A total of 21 cases of basal ganglia germinomas (BGG) in children were analyzed according to clinical characteristics, neuroimaging data and tumor markers from November 2006 to January 2017. Results BGG was characterized in male adolescents with progressive hemiparesis, intelligent deficiency and high level of serum HCG. The basal ganglia space-occupying lesion oppressed the ventricle with ipsilateral temporal lobe atrophy in brain CT. Tumor parenchyma was shown with isointense or heterogeneous enhancement on MRI T1 weighted images; T2 weighted images showed obvious local occupying effect and the atrophy of temporal lobe with widening of cerebral sulci and cisterns. After diagnostic radiotherapy, the tumor volume reduced obviously, and the patients could be cured completely by further combination of chemotherapy with radiotherapy. Conclusion The diagnosis of basal ganglia germinomas should be considered in the male children around 11 years old with progressive hemiparesis, intelligent deficiency, high HCG level of serum or CSF, and the basal ganglia with no obvious boundary space-occupying lesion and the ipsilateral temporal lobe atrophy in neuroimaging. It can be further confirmed by diagnostic radiotherapy and then the patients should receive further chemotherapy with combination of radiotherapy so as to reduce the risk of surgery.

Key words: Basalganglia; Germinoma; Radiotherapy; Chemotherapy; Diagnostic , radiotherapy