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What

Germinomas are a type of germ cell tumor which can occur within the central nervous system (CNS) and a type of malignant brain tumors. They are thought to originate from transformation of germ cells (sex cells) that have inappropriately migrated into or failed to migrate out of the brain during fetal development. This type of tumor has the potential to spread to the lungs, bone and spine.

Who

The incidence of germ cell tumors in the United States is approximately 50 new cases each year. Of these, 50% are germinomas. The most common age of diagnosis is in adolescence. Approximately 70% of individuals with germinomas are diagnosed between 10 and 21 years of age. Germinomas are more common in males, and the ratio is 2.24 male to 1 female. Germinomas within the CNS, for males, tend to be located in the pineal region, which is the middle-back portion of the brain. In comparison, in females, the germinoma tends to be located in the suprasellar region, which is at the base of the skull near the front.

Signs and Symptoms

Children with a CNS germinoma often present with the following symptoms depending on where they are located in the brain: 1. hypothalamic-pituitary dysfunction (hormonal/endocrine problems, such as precocious puberty) 2. visual-field deficits/double vision 3. disturbances of memory or mood 4. hydrocephalus (blockage of cerebral spinal fluid) 5. nausea/vomiting 6. excessive thirstiness 7. poor appetite

Possible Causes

What causes a germinoma is not exactly known. It has been suggested that the tumor results from inappropriate migration of germ cells into the brain or failure of germs cells to migrate out of the brain while it is being developed.

Diagnosis

The best diagnostic test for a CNS germinoma is an MRI of the head which is read by a special type of radiologist called a neuroradiologist. A germinoma can also be diagnosed by examining the cerebral spinal fluid for the presence of certain cells which are viewed under the microscope. The tumor may also secrete certain types of tumor markers called, alpha fetoprotein (AFP) or beta subunit of human chorionic gonadotropin (_-HCG). _-HCG is usually the tumor marker associated with germinoma whereas AFP is elevated with other types of germ cell tumors. These tumor markers can be elevated both in the serum as well as in the cerebrospinal fluid (which is obtained by doing a lumbar puncture.)

Treatment

Treatment of children with germinoma involves complete surgical removal of the tumor. If this is not possible, focal radiation can be performed. Chemotherapy can also used in combination with surgery or radiation.

Prognosis

The prognosis for a child with a germinoma is fairly good. The survival rate at five years is greater than 85% given that the tumor was successfully removed and/or responds well to chemo or radiation therapy.

Connect with other parents

In the spirit of community and support, Madisons Foundation offers the unique service of connecting parents of children with rare diseases. If you would like to be connected to other parents of children with this disease, please fill out this brief form.

Weblinks

American Brain tumor Association
An outstanding website and detailed information about germinomas as well as links to support groups and ongoing research.

Brain tumors
This website provides easy to understand information for parents as well as links to support networks and other informative websites.

Children's Brain tumor Foundation
A great website with well written information about germinomas as well as links to support networks.

Google Search for Intracranial Germinomas

References and Sources

www.brain-tumour.net/tumours/germ2.htm www.emedicine.com/med/topic2246.htm www.cinn.org/ibsc/braintumors/diagnoses/germinoma.html