[Successful treatment with combined chemotherapy (carboplatin, etoposide, adriamycin, bleomycin) and radiotherapy for recurrent intracranial malignant germ cell tumor: case report].

We report a case of a patient with recurrent malignant germ cell tumor who was successfully treated with carboplatin combination followed by radiation therapy. A 13 year-old female presented with diabetes insipidus six years ago. From the homogeneous tumor intensity on CT scan and negative titer of AFP and HCG, we made a diagnosis of suprasellar germinoma, and treated her with radiation therapy (40Gy), which resulted in almost complete disappearance of the tumor. The tumor recurred six years later in the primary region and in the cervical spinal cord with elevated AFP titer (160ng/ml) and HCG titer (404mlU/ml). She was treated with multi-agents chemotherapy consisting of carboplatin (450mg/m2, day 1), etoposide (150mg/m2, days 1-3), adriamycin (30mg/m2, day 1), and bleomycin (20mg/m2, days 1 and 8), followed by radiation therapy to the whole brain (20Gy), the whole spine (30Gy) and the cervical spine (20Gy). The tumors completely disappeared. We discuss treatment failures of clinically diagnosed germinoma without histological verification, and effective aggressive chemotherapy for recurrent malignant germ cell tumors.