Management of primary intracranial germinomas: diagnostic surgery or radical resection?

• DOI: 10.3171/jns.1997.87.2.0262
• Publication Date: 2009-06-10T18:34:31Z
• Authors: Yutaka Sawamura; Nicolas de Tribolet; Nobuaki Ishii; Hiroshi Abe
• Keywords: Germinoma; Pinealoma; Hemiparesis; Stereotactic biopsy

✓ Because intracranial germinomas are readily curable with radiation and chemotherapy or therapy alone, the role of radical surgery has become debatable. This study assesses optimum degree surgical resection for germinomas. Twenty-nine patients who underwent germinoma were retrospectively analyzed (male/female ratio 27:2, median age 18 years). Among these 29 there 10 solitary pineal, seven neurohypophyseal/hypothalamic, 12 multifocal disseminated tumors. Biopsy samples obtained in 16 (stereotactically eight, transsphenoidally four, via frontotemporal craniotomy four). Partial was attained five (via a approach three occipitotranstentorially two). Gross-total achieved an occipitotranstentorial route eight pineal masses. After surgery, treated radiotherapy 19 received chemotherapy; complete remission all patients. The overall tumor-free survival rate 100% at follow-up period 42 months. There no significant difference outcome related to extent resection. Postoperative neurological improvement seen only two patients, whereas transient postoperative complications, mainly upgaze palsy, observed six. One patient experienced slight hemiparesis, bringing morbidity 3% (one 29). It is concluded that offers benefit over biopsy. primary goal should be obtain sufficient volume tumor tissue histological examination. If strong evidence on radiological studies, biopsy obtained. When perioperative diagnosis pure made during craniotomy, risk taken continuing