Cerebral germinoma with syncytiotrophoblastic giant cells: Feasibility of predicting prognosis using the serum hCG level

As the biological behaviour of germinoma with syncytiotrophoblastic giant c ells (STGC) is not well established, the present study was undertaken to as certain the prognostic significance of serum hCG level in affected patients . Of a total of 23 cases studied, 12 patients were regarded as pure germino mas and 11 were germinomas with STGC. All but one of the former demonstrate d an excellent outcome. The exception developed subarachnoid metastases, bu t the tumour disappeared on radiation therapy and the patient is enjoying a normal social life 13 years after the initial treatment. With the germinom a complicated by STGC, 3 cases showed local recurrence which were followed by a poor outcome. Their pretreatment hCG levels were 15.0, 26.0 and 29.6 m IU/ml respectively. The study showed a tendency, in germinomas with STGC, f or a positive association between serum hCG, and the likelihood of a poor o utcome. Germinomas with STGC and serum hCG levels higher than 15 mIU/ml thu s have a high recurrence rate, and more aggressive treatment is indicated f or the affected patients.