MIXED GERM-CELL TUMOR OF THE BRAIN - PATHOLOGICAL-STUDY OF 6 AUTOPSY CASES

Intracranial mixed germ-cell tumors are rare. We describe the findings from six autopsies of patients with these tumors. The patients were a ll young at presentation (mean age, 16 years), and five of the six wer e male. Headache, vomiting, polyuria and diplopia were common symptoms . Radiographic evaluation demonstrated a mass on the midline of the br ain. The patients were treated mainly with radiation, but survival (me an, 3.7 years) was not as long as predicted. At autopsy the tumors occ upied most of the ventricular spaces, and ranged from being well-circu mscribed to invasive. All tumors contained both germinoma components a nd nongerminomatous germ-cell tumor components. Because the distributi on of these components was not homogeneous, at least two sections were necessary for the diagnosis. Immunoreactivity for placental alkaline phosphatase was found in all tumors. Immunostaining for human choriona l gonadotropin, alpha-fetoprotein and carcinoembryonic antigen was usu ally associated with abnormally high serum levels of these tumor marke rs in life. A number of the cells in both kinds of tumor components ex pressed proliferating cell nuclear antigen, probably reflecting the in tense malignant potential.