ArticleJournal of neurosurgery. Case lessons2025
Mature teratoma with a germinoma component presenting with undetectable placental alkaline phosphatase in cerebrospinal fluid: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Elevation of hCG in CSF in pinealoblastoma: a pitfall rescued by pathological examination.Acta neuropathologica communications · 2025Article
- Sensitivity and specificity of cerebrospinal fluid placental alkaline phosphatase in germinoma: An 8 pg/mL threshold.Neuro-oncology advancesArticle
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnosing intracranial mixed germ cell tumors (GCTs) can be challenging due to intratumoral heterogeneity. Placental alkaline phosphatase (PLAP) in the cerebrospinal fluid (CSF) is a highly sensitive and specific marker for identifying pure germinomas and germinoma components within mixed GCTs. OBSERVATIONS: The authors present the case of a 6-year-old boy presenting with a 5-day history of vomiting and headache. Magnetic resonance imaging revealed a heterogeneously enhanced mass with cystic areas in the pineal region. Preoperative serum levels of alpha-fetoprotein and human chorionic gonadotropin, as well as CSF PLAP levels, were not elevated, leading to a preliminary diagnosis of mature teratoma. The tumor was completely resected, and pathological examination of the resected tissue confirmed a mature teratoma with germinoma components. Given the diagnosis of mixed GCT with a germinoma component, the patient underwent postoperative radiation chemotherapy. There has been no recurrence after 8 years of follow-up. LESSONS: In this case, the preoperative CSF PLAP level failed to predict the presence of a germinoma component. This report highlights a potential limitation of CSF PLAP as a diagnostic marker, noting that CSF PLAP may be undetectable if the germinoma is confined to a localized area. https://thejns.org/doi/10.3171/CASE24588.
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