Germ Cell Tumors originating in the Basal Ganglia and Thalamus

Abstract

Two patients with germ cell tumors of the basal ganglia and the thalamus are described. A 10year-old boy developed left hemiparesis and precocious puberty. Computed tomography (CT) of the brain revealed a small lesion in the right basal ganglia, which appeared to be rapidly growing. Elevation of human chorionic gonadotropin (HCG) in both serum and cerebrospinal fluid was compatible with germ cell tumor. A craniotomy was performed and the tumor was partially removed. Histological examination verified a mixed-type germ cell tumor composed of embryonal carcinoma, choriocarcinoma, and germinoma. An 11-year-old boy complained of right hemiparesis, and a CT scan showed a well-enhanced, cystic tumor in the left thalamic region. The tumor was partially resected and was diagnosed histologically as germinoma. A high level of HCG was found in the contents of the cyst. HCG and alpha-fetoprotein, which are so-called tumor markers, decreased over the course of treatment in both cases, and seemed to be indicators of the effectiveness of treatment. However, the authors feel that the differential diagnosis of germ cell tumors cannot be based solely on the level of these tumor markers. The characteristic features of germ cell tumors of the basal ganglia and thalamus are discussed.

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