Primary medulla oblongata germinomas: two case reports and review of the literature

World Journal of Surgical Oncology

Liwei Zhang¹  Junting Zhang¹  Zhen Wu¹  Liang Wang¹  Jie Feng²  Da Li¹  Shuyu Hao¹ 

[1] Department Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, NO.6 Tiantan Xili Dongcheng district, Beijing 100050, P R China;Beijing Neurosurgical Institute, Capital Medical University, NO.6 Tiantan Xili Dongcheng district, Beijing 100050, P R China

关键词: Treatment;    Medulla oblongata;    Germinoma;   

Others  :  821211
DOI  :  10.1186/1477-7819-11-274

 received in 2013-02-02, accepted in 2013-09-20,  发布年份 2013

【 摘 要 】

An intracranial germinoma is a tumor that is sensitive to radiotherapy. As medulla oblongata germinomas are extremely rare, determining an accurate preoperative diagnosis is challenging. Two cases of medulla oblongata lesions were surgically treated, and a postoperative diagnosis of germinoma was determined in both of the cases. The tumor in one patient completely resolved after a treatment course consisting of surgical intervention, radiotherapy and chemotherapy; the other patient, who did not receive any type of adjuvant treatment after surgery, suffered from tumor relapse and died from pneumonia 8 months following surgery. A preoperative diagnosis of medulla oblongata germinoma is difficult because of the lack of specific clinical signs and symptoms. If the correct diagnosis is reached, patients can have a favorable prognosis with proper evaluation and treatment. An invasive operation can potentially lesion and impair the function of the medulla oblongata, which is fatal to the patient.

【 授权许可】

   
2013 Hao et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Finlay J, Da SN, Lavey R, Bouffet E, Kellie SJ, Shaw E, Saran F, Matsutani M: The management of patients with primary central nervous system (CNS) germinoma: current controversies requiring resolution. Pediatr Blood Cancer 2008, 51:313-316.
• [2]Shuto T, Ohtake M, Matsunaga S, Hasegawa N: Primary medulla oblongata germinoma in a male patient. J Clin Neurosci 2012, 19:769-771.
• [3]Yasuhara T, Ichikawa T, Miyoshi Y, Kurozumi K, Maruo T, Yanai H, Date I: Primary germinoma in the medulla oblongata - case report -. Neurol Med Chir (Tokyo) 2011, 51:326-329.
• [4]Akimoto J, Murakami M, Fukami S, Ikeda Y, Haraoka J: Primary medulla oblongata germinoma–an unusual posterior fossa tumors in young adults. J Clin Neurosci 2009, 16:705-708.
• [5]Yen PS, Chou AS, Chen CJ, Jung SM, Chuang HL, Scott RM: Primary medulla oblongata germinoma: a case report and review of the literature. J Neurooncol 2003, 62:339-342.
• [6]Hu YW, Huang PI, Wong TT, Ho DM, Chang KP, Guo WY, Chang FC, Shiau CY, Liang ML, Lee YY, Chen HH, Yen SH, Chen YW: Salvage treatment for recurrent intracranial germinoma after reduced-volume radiotherapy: a single-institution experience and review of the literature. Int J Radiat Oncol Biol Phys 2012, 84:639-647.
• [7]Chen YW, Huang PI, Ho DM, Hu YW, Chang KP, Chiou SH, Guo WY, Chang FC, Liang ML, Lee YY, Chen HH, Hsu TR, Lin SC, Wong TT, Yen SH: Change in treatment strategy for intracranial germinoma: long-term follow-up experience at a single institute. Cancer 2012, 118:2752-2762.
• [8]Nakatsuka S, Tateishi A, Nagano T, Kimura H, Nakajo K, Takahashi J, Taki T: Primary extragonadal germinoma of the medulla oblongata. Int J Surg Pathol 2012, 20:276-279.
• [9]Neelima R, Mathew A, Kapilamoorthy TR, Radhakrishnan VV: Germinoma of medulla. Neurol India 2010, 58:768-770.
• [10]Hao S, Liu B, Tang J, Jia G, Zhang Y, Ma Z, Wang Z: Germinoma of basal ganglia in female: case report and review of the literature. Childs Nerv Syst 2009, 25:613-617.
• [11]Nakajima H, Iwai Y, Yamanaka K, Yasui T, Kishi H: Primary intracranial germinoma in the medulla oblongata. Surg Neurol 2000, 53:448-451.
• [12]Sugiyama K, Uozumi T, Goishi J, Sogabe T, Arita K, Maeda H, Ikawa F: Germinoma of the medulla oblongata–case report. Neurol Med Chir (Tokyo) 1994, 34:291-294.
• [13]Tashiro T, Yoshida J, Wakabayashi T, Sugita K, Abe H: Primary intracranial germinoma involving the medulla oblongata–case report. Neurol Med Chir (Tokyo) 1993, 33:251-254.
• [14]Hashimoto M, Hatasa M, Shinoda S, Masuzawa T: Medulla oblongata germinoma in association with klinefelter syndrome. Surg Neurol 1992, 37:384-387.
• [15]Poungvarin N, Nimmannitya J, Issaragrisil R, Sangruchi T: Brainstem germinoma presenting as intermittent apnoea: a rare entity: report of one patient and review of literature. J Med Assoc Thai 1991, 74:55-60.