[Primary intracranial germ cell tumor in the right basal ganglia and its vicinity area--a report of the case with germinoma and choriocarcinoma histologically].

A case of intracranial germ cell tumor in the right basal ganglia and it's vicinity area was presented and previous reported cases were reviewed. The patient was a 11-year-old boy with precocious puberty. His illness started with left hemiparesis and mental disturbance, i.e. behavioral and emotional change one year prior to admission. Enhanced CT demonstrated a round lesion of high density, with relatively low density in the center portion. The tumor developed from the right putamen to thalamus, and involved toward hypothalamic region on coronary CT. Hormonal studies revealed abnormal levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), human chronic gonadotropin (HCG), and testosterone. In addition to excessively high levels of HCG in the urine, serum and CSF, high elevation of plasma LH and low of plasma FSH were revealed. On 3 June 1980, right temporal craniotomy was performed and a piece of the tumor was removed. Tumor's tissue was diagnosed as germinoma by pathohistological examination. As the effect of postoperative Co-60 radiation, high density area on CT disappeared and remained as well margined low density area. On repeated CTs and HCG-measurements on further, recurrent sign was not noted up to now. However, as a result of pathohistological studies in details, syncytiotrophoblast generally seen in the choriocarcinoma seem to be presented in it's tissue. Therefore, by means of peroxidase labeled antibody method, the authors proved HCG in syncytial cells of the tumor's tissue. There are very little reports on quantification of HCG in primary intracranial germ cell tumor with precocious puberty. Serial measurements of HCG are useful for following the diagnosis and therapy of primary intracranial germ cell tumors. In this report, the authors provide evidence that the syncytial cell mixed in intracranial germinoma secrets HCG.