ArticleNeuro-oncology2013
Bifocal intracranial tumors of nongerminomatous germ cell etiology: diagnostic and therapeutic implications.
Article in Neuro-oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- The Japan Society for Neuro-Oncology guideline on the diagnosis and treatment of central nervous system germ cell tumors.Neuro-oncology · 2022Guideline
- Low-Level Cerebrospinal Fluid β-hCG Elevation in Patients with Pineal Parenchymal Tumors: A Four-Case Series and Diagnostic Caution.Journal of clinical medicine · 2026Article
- Cerebrospinal Fluid Genomic Profiling as an Adjunct in a Case of Intracranial Germinoma: Utility and Limitations.Diagnostics (Basel, Switzerland) · 2026Article
- Simultaneous occurrence of bilateral retroperitoneal neuroblastoma and bifocal malignant mixed germ cell tumor in a pediatric patient with 16p11.2 microdeletion syndrome: a case report.Frontiers in endocrinology · 2025Article
- Bifocal germ cell tumor of pineal germinoma and neurohypophyseal embryonal carcinoma: illustrative case.Journal of neurosurgery. Case lessons · 2024Article
- Effect of delayed diagnosis on neuroendocrine function in individuals with suprasellar germ cell tumors.Frontiers in endocrinology · 2024Article
- Update on MRI in pediatric intracranial germ cell tumors-The clinical and radiological features.Frontiers in pediatrics · 2023Review
- Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience.Frontiers in oncology · 2023Article
- Article
- EANO, SNO and Euracan consensus review on the current management and future development of intracranial germ cell tumors in adolescents and young adults.Neuro-oncology · 2022Article
- Advances in Molecular Profiling and Developing Clinical Trials of CNS Germ Cell Tumors: Present and Future Directions.Current oncology reports · 2022Review
- So-called bifocal tumors with diabetes insipidus and negative tumor markers: are they all germinoma?Neuro-oncology · 2021Article
- Unusual presentation of the germinoma: A 26-year-old female.Caspian journal of internal medicine · 2021Article
- Article
- Integrated clinical, histopathological, and molecular data analysis of 190 central nervous system germ cell tumors from the iGCT Consortium.Neuro-oncology · 2019Article
- Indications for salvage surgery during treatment for intracranial germ cell tumors.Journal of neuro-oncology · 2018Article
- Primary Central Nervous System Germ Cell Tumors: A Review and Update.Medical research archives · 2018Article
- Reduced-volume radiotherapy for patients with localized intracranial nongerminoma germ cell tumors.Journal of neuro-oncology · 2017Article
- MRI features of pediatric intracranial germ cell tumor subtypes.Journal of neuro-oncology · 2017Article
- Understanding the Treatment Strategies of Intracranial Germ Cell Tumors: Focusing on Radiotherapy.Journal of Korean Neurosurgical Society · 2015Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients presenting with synchronous bifocal intracranial tumors (masses in the pineal and neurohypophyseal region), detectable human chorionic gonadotropin (hCG) levels (5-100 mIU/mL), and normal alpha feto-protein (AFP) levels (≤10 ng/mL) are often diagnosed empirically with pure germinoma. In such scenarios, pathologic confirmation is often deferred, given that bifocal nongerminomatous germ cell tumors (NGGCTs) are considered rare and because available literature and research protocols support such an approach. We sought to characterize the association between bifocal intracranial tumors and NGGCT histology.
methodsSeventy-one patients treated for intracranial germ cell tumors at Massachusetts General Hospital in 1998-2012 were identified. Patients presenting with synchronous bifocal disease were selected for further review.
resultsOf the 71 patients presenting with intracranial germ cell tumors, 14 (19.7%) had synchronous bifocal disease. Of these 14 patients, 7 (50.0%) had germinoma, 3 (21.4%) had NGGCT, and 4 (28.6%) had hCG levels <200 mIU/mL and normal AFP levels and were treated without pathologic confirmation. Of the 3 patients with confirmed bifocal NGGCT, 2 had detectable hCG levels with AFP <10 ng/mL and 1 patient had a detectable hCG level with a modest elevation in AFP.
conclusionsNGGCTs should be considered in the differential diagnosis for patients presenting with bifocal intracranial tumors. Given differences in the management of germinomas and NGGCTs, clinicians should strongly consider a biopsy in patients presenting with bifocal masses and normal or modestly elevated biomarkers. Misclassification of such cases as germinomas could result in undertreatment and a possible increased risk for recurrence.
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