SPONTANEOUS REGRESSION OF PRIMARY INTRACRANIAL GERMINOMA - A CASE-REPORT

BACKGROUND. Testicular seminomas are well known to regress spontaneous ly at a higher incidence than other tumors. To date, there have been n o reports of spontaneous regression of an intracranial germinoma, alth ough these tumors are histologically identical to testicular seminomas . METHODS. The authors present a patient with a primary intracranial g erminoma that regressed spontaneously. RESULTS. A 21-year-old man was admitted to the study facility with acute onset of headache and vomiti ng. He had a 3-year history of polydipsia and polyuria. Computed tomog raphy (CT) demonstrated a large tumor in the third ventricle, accompan ied by hydrocephalus. He underwent ventriculoperitoneal shunt placemen t on the second day of hospitalization. A CT scan obtained on the fift h postoperative dap demonstrated a remarkable decrease in tumor size, Because serial magnetic resonance imaging (MRI) demonstrated a gradual decrease in tumor size, tumor resection was nor performed at that tim e. The patient tvas discharged and followed with MRI. The tumor contin ued to regress for more than 2 months. The patient was readmitted due to tumor regrowth, confirmed by MRI 4 months after the initial admissi on, despite the absence of symptom exacerbation. Two weeks later, the suprasellar portion of the tumor was resected through a right frontote mporal craniotomy. The histopathologic diagnosis was a germinoma. No c oncurrent tumors were found on whole body examination. The residual tu mor gradually regressed after conventional radiation therapy and there has been neither tumor recurrence nor metastasis to date, CONCLUSIONS . Although the precise cause of the transient partial regression is un known, this case indicates that, like their testicular counterparts, i ntracranial germinomas may on occasion spontaneously regress. (C) 1997 American Cancer Society.