INTRACRANIAL GERM-CELL TUMORS IN ADULTS

Intracranial germ cell tumors in adults. A retrospective study of 19 c ases. The authors report an the retrospective analysis of 19 patients with primary cerebral germ cell rumors which were treated between 1965 and 1993. Median age is 18 years (extremes: 16-55 years). There were 16 men and three women. The location of the primary tumor was the pine al area in sir patients, suprasellar and hypothalamic area in five pat ients and other areas in eight patients. The histological pattern was Iron seminoma in six patients, dysgerminoma in eight; however no histo logical sample was obtained in five patients who did not have any part icular characteristics (either cytological abnormalities or elevated t umor marker level). Three patients were treated by surgery only, eight patients received exclusive radiotherapy and eight patients had first line chemotherapy and further cranial irradiation. One was lost to fo llow up. Sir of eight assessable patients with dysgerminoma are alive with non evolutive disease (NED) after 15 to 176 month of follow-up. O ne out of five assessable patients with non seminomatous tumor in NED (163 month of follow-up). Finally all five patients who have no histol ogical subtyping are alive with NED at 24 to 138 months. The standard treatment of dysgerminoma is currently first line chemotherapy followe d by relatively low-dose and limited irradiation; the standard treatme nt of non-seminomatous cerebral germ cell tumor is chemotherapy, the s tudy of which is warranted with the aim to decrease the toxicity and t o increase the efficacy.