Bazzi Nagham, Saad Wajih A, Bazzi Hala, Almokdad Mohammad Ali, Mghames Abdo
Medicine, Lebanese University, Beirut, LBN.
Oncology, Lebanese University Faculty of Medicine, Beirut, LBN.
Cureus. 2024 Jan 31;16(1):e53325. doi: 10.7759/cureus.53325. eCollection 2024 Jan.
Intracranial germ cell tumors (GCTs) are rare malignant tumors with a peak incidence around puberty. The pineal region is the most commonly involved area of all intracranial GCTs. Due to the heterogeneous tumor origin, subtypes, and presentation, diagnosis and management are challenging. Complicated pineal germinomas are rarely reported in the literature. Here, we report a rare case of pineal germinoma with hydrocephalus and discuss the potential treatment approach. A 20-year-old boy presented to the hospital with vomiting and a decreased level of consciousness. The brain magnetic resonance imaging (MRI) revealed a pineal tumor. A ventriculoperitoneal shunt was placed to relieve the increased intracranial pressure. The patient underwent a suboccipital craniotomy with excisional biopsy of the pineal region tumor due to its critical location, as imaging studies alone may not be sufficient to establish a definitive diagnosis. Although there has been a rise in reported cases of germinoma tumors, there is currently no standardized therapeutic approach for treating them. Therefore, more randomized controlled cohort studies are necessary to evaluate potential treatments and develop a therapeutic approach.
颅内生殖细胞肿瘤（GCTs）是罕见的恶性肿瘤，在青春期前后发病率达到高峰。松果体区是所有颅内GCTs最常累及的区域。由于肿瘤起源、亚型和表现的异质性，诊断和治疗具有挑战性。文献中很少报道复杂的松果体生殖细胞瘤。在此，我们报告一例罕见的松果体生殖细胞瘤合并脑积水病例，并讨论潜在的治疗方法。一名20岁男孩因呕吐和意识水平下降入院。脑部磁共振成像（MRI）显示松果体区有肿瘤。因颅内压升高，放置了脑室腹腔分流管以缓解症状。由于肿瘤位置关键，仅靠影像学检查可能不足以明确诊断，患者接受了枕下开颅手术，对松果体区肿瘤进行切除活检。尽管生殖细胞瘤的报告病例有所增加，但目前尚无标准化的治疗方法。因此，需要更多的随机对照队列研究来评估潜在的治疗方法并制定治疗方案。
