Control of extraneural metastasis of a primary intracranial nongerminomatous germ-cell tumor. Case report.

Primary intracranial germ-cell tumors are infrequently occurring neoplasms which most often arise in the pineal or sellar regions. Germinomas are seen more frequently than nongerminomatous germ-cell tumors; they are often curable with radiotherapeutic approaches, or with chemotherapy in the rare instance of extraneural metastasis. Nongerminomatous germ-cell tumors are relatively radioresistant and when extraneural metastasis has occurred, they have been fatal in all of the 32 previously reported cases. The case of a 14-year-old girl with a mixed malignant germ-cell tumor arising in the pineal region is reported. Extraneural metastasis to the lung developed 12 months after whole-brain radiotherapy was completed. She was treated with etoposide (VP-16), high-dose cisplatin, vinblastine, and bleomycin and is currently without evidence of disease 46 months postmetastasis.