GERM-CELL TUMOR IN THE HYPOTHALAMONEUROHYPOPHYSEAL REGION - CLINICAL-FEATURES AND TREATMENT

Twenty-one patients with germ cell tumors (17 germinomas and 4 teratom as) involving the hypothalamic-neurohypophysial (HN) region were revie wed retrospectively. Eleven patients were males and 10 females, and th eir ages ranged from 7 to 45 years (average 18.5 years). Diabetes insi pidus was the initial and the most prominent symptom in most germinoma s; in teratomas the most prominent symptom was visual disturbance. Fif teen patients with germinomas were treated by radiotherapy, and 4 with teratomas were treated by surgical resection alone. Two recent germin oma patients with extensive CSF dissemination were treated with system ic chemotherapy consisting of anticancer platinum drugs and etoposide, which resulted in a complete disappearance of the tumors. Patients wi th germinoma treated after the introduction of CT scanning had a great ly improved mortality rate, and their actual survival rate was 87.5% o ver 10 years. On the basis of this review, the authors consider that d iagnosis at an early stage of the disease and chemotherapy, which can be an effective therapeutic alternative to radiation therapy, may impr ove not only the mortality rate but also the quality of life of patien ts with HN germ cell tumors.