Summary
A histological study has been made of a retrospective series of 17 primary intracranial germ cell tumours found in a collection of 3550 intracranial neoplasms (incidence of 0.48%). All, except for two differentiated teratomas (one extracerebral in a neonate and another in the lateral ventricle), were situated in the midline in persons aged 5 to 37 years (13 males, 4 females). 12 tumours were located in or originated from the (para)pineal region, two of them also invaded the hypothalamus, while three germinomas occupied the retrochiasmal (supra/intrasellar) region without pineal involvement. There were 11 rather pure tumours (7 germinomas, 4 teratomas of various differentiation) and six “mixed” neoplasms (2 germinomas with teratoid areas, 3 embryonal carcinomas containing elements of endodermal sinus tumour, choriocarcinoma and germinoma, and one teratocarcinoma with endodermal sinuses). Only one case showed prominent features of endodermal sinus tumour, but characteristic elements of this type were present in four other “mixed” tumours. All germinomas and germinomatous parts of mixed neoplasms showed an inflammatory reaction of varying intensity, in 6 cases associated with multinucleated giant cells, which may be related to the prognosis of these tumours (one patient with hypothalamic germinoma is alive 6 years after radiotherapy). The close structural similarities between the various types of intracranial and gonadal dysgerminomas and their frequent combination within the same tumour support the concept of a common histogenesis of germ cell tumours regardless of their site of origin. Difficulties of classification may arise from the rather frequent occurrence of “mixed” germ cell neoplasms.
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Albrechtsen, R., Klee, J. G., Møller, J. E.: Primary intracranial germ cell tumours including five cases of endodermal sinus tumour. Acta path. microbiol. scand., Sect. A80, Suppl.233 32–38 (1972)
Araki, C., Matsumoto, S.: Statistical reevaluation of pinealoma and related tumors in Japan. J. Neurosurg.30, 146–149 (1969)
Askanazy, M.: Die Teratome nach ihrem Bau, ihrem Verlauf, ihrer Genese und in Vergleich zum experimentellen Teratoid. Verh. dtsch. path. Ges.11, 39–82 (1907)
Beck, J. S., Fulmer, H. F., Lee, S. T.: Solid malignant ovarian teratoma with “embryoid bodies” and trophoblastic differentiation. J. Path. (Edinbg.)99, 67–73 (1969)
Bestle, J.: Extragonadal endodermal sinus tumours originating in the region of the pineal gland. Acta path. microbiol. scand.74, 214–222 (1968)
Borit, A.: Embryonal carcinoma of the pineal region. J. Path. (Edinbg.)97, 165–168 (1969)
Bradfield, J. S., Perez, C. A.: Pineal tumors and ectopic pinalomas. Analysis of treatment and failures. Radiology103:399–406 (1972)
Bruton, O. C., Martz, D. C., Gerard, E. S.: Precocious puberty due to secreting chorionepithelioma (teratoma) of the brain. J. Pediat.59:719–725 (1961)
Collins, D. H., Pugh, R. C. B.: The pathology of testicular tumours. Brit. J. Urol., Suppl.36, No. 2, (1964)
Curri, S. B., Raso, M., Rossi, C.: Die Anwendung der Dünnschichtchromatographie zum Nachweis von Fett und Lipoidsubstanzen in Gewebsschnitten. Histochemie4, 113–119 (1964)
Dastur, D. K., Lalitha, V. S.: Pathological analysis of intracranial space-occupying lesions in 1000 cases including children. Part 4. Pituitary adenomas, developmental tumours; parasitic and developmental cysts. J. neurol. Sci.15, 397–427 (1972)
Dayan, A. D., Marshall, A. H. E., Miller, A. A., Pick, F. J., Rankin, N. E.: Atypical teratomas of the pineal and hypothalamus. J. Path. Bact.92, 1–28 (1966)
Dixon, F. J., Moore, R. A.: Tumors of the male sex organs. Atlas of tumor pathology. Sect. VIII. Fasc. 31b and 32. Washington, D. C.: Armed Forces Institute of Pathology 1952
Friedman, N. B.: Germinoma of the pineal: Its identity with germinoma (“seminoma”) of the testis. Cancer Res.7, 363–368 (1947)
Ghatak, N. R., Hirano, A., Zimmerman, H. M.: Intrasellar germinomas: A form of ectopic pinealoma. J. Neurosurg.31, 670–675 (1969)
Herrschaft, H.: Die Teratome des Zentralnervensystems. Dtsch. Z. Nervenheilk.194, 344–365 (1968)
Holczabek, W.: Dünnschichtchromatographische Untersuchung von Gewebsschnitten. Dtsch. Z. ges. gerichtl. Med.57, 211–214 (1966)
Jellinger, K.: Cerebral medulloepithelioma. Acta neuropath. (Berl.)22, 95–101 (1972)
Jellinger, K., Minauf, M., Kraus, H., Sunder-Plaszmann, M.: Embryonales Carcinom der Epiphysenregion. Acta neuropath. (Berl.)15, 176–182 (1970)
Kageyama, N., Belsky, R.: Ectopic pinealoma in the chiasma region. Neurology (Minneap.)11, 318–327 (1961)
Kalm, H., Magun, R.: Beitrag zur Klinik und pathologischen Anatomie der Pinealome. Dtsch. Z. Nervenheilk.164, 453–468 (1950)
Katsura, S., Suzuki, J., Wada, T.: A statistical study of brain tumors in the neurosurgical clinics in Japan. J. Neurosurg.16, 570–580 (1959)
Lachmann, D., Jellinger, K., Sunder-Plaszmann, M.: Großes intrakranielles Teratom beim Neugeborenen. Z. Kinderchir.9, 15–20 (1970)
Lascelles, P. T., Lewis, P. D.: Hypodipsia and hypernatraemia associated with hypothalamic and suprasellar lesions. Brain95, 249–264 (1972)
Lauder, I., Aherne, W.: The significance of lymphocytic infiltration in neuroblastoma. Brit. J. Cancer26, 321–330 (1972)
Luccarelli, G.: Ectopic pinealomas of the optic nerves and chiasma. Acta neurochir. (Wien)27, 205–221 (1972)
Marshal, A. H. E., Dayan, A. D.: An immune reaction in man against seminomas, dysgerminomas, pinealomas, and the mediastinal tumours of similar histological appearance. Lancet1964 1102–1104
Mintz, B.: Formation and early development of germ cells. Milan: Fond. A Baselli, Istituto lombardo 1961
Mintz, B., Russell, E. S.: Gene-induced embryological modifications of primordial germ cells in the mouse. J. exp. Zool.134, 207–237 (1957)
Mostofi, F. K., Price, E. B., Jr.: Tumors of male genital system. In: Atlas of tumor pathology, ser. 2, fasc. 7. Washington, D.C.: Armed Forces Institute of Pathology 1972
Nishiyama, R. H., Batsakis, J. G., Weaver, D. K., Simrall, J. M.: Germinal neoplasms of the central nervous system. Arch. Surg.93, 342–347 (1966)
Oswald, U., C. Hedinger: Intrakranielle Keimzelltumoren (Teratome und Seminome). Virchows Arch., Abt. A, Path. Anat.357, 281–298 (1972)
Pierce, S. B., Abell, M. R.: Embryonal carcinoma of the testis. Path. Ann. (N.Y)5, 27–60 (1970)
Ramsey, H. J.: Ultrastructure of a pineal tumor. Cancer (Philad.)18, 1014–1025 (1965)
Rubinstein, L. J.: Tumors of the central nervous system. In: Atlas of tumor pathology. 2nd ser., fasc. 6. Washington, D. C.: Armed Forces Institute of Pathology 1972
Russel, D. S.: The pinealoma: Its relationship to teratoma. J. Path. Bact.56, 145–150 (1944)
Simson, L. R., Lampe, I., Abell, M. R.: Suprasellar germinomas. Cancer (Philad.)22, 533–544 (1968)
Stowell, R. E., Sachs, E., Russell, W. O.: Primary intracranial chorioepithelioma with metastases to the lungs. Amer. J. Path.21:787–801 (1945)
Tabuchi, K., Yamada, O., Nishimoto, A.: The ultrastructure of pinealoma. Acta neuropath. (Berl.)24, 117–127 (1973)
Teilum, G.: Classification of endodermal sinus tumours (mesoblastoma Vitellinum) and so-called “embryonal carcinoma” of the ovary. Acta path. microbiol. scand.64, 407–429 (1965)
Teilum, G.: Special tumors of the ovary and testis and related extragonadal lesions. Comparative pathology and histological identification. Copenhagen: Munksgaard 1971
Warzok, R., Arnold, H.: Zur Problematik der intrakraniellen Dysgerminome. Zbl. allg. Path. path. Anat.115, 67–73 (1972)
Witschi, E.: Migration of the germ cells of human embryos from the yolk sac to the primitive gonadal folds. Contr. Embryol. Carneg. Instn32, 67–80 (1948)
Zülch, K. J.: Biologie und Pathologie der Hirngeschwülste. In: Handb. Neurochir., Bd. 3. Berlin-Heidelberg-New York: Springer 1956
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Dedicated to E. Frauchiger, on the occasion of his 70th anniversary.
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Jellinger, K. Primary intracranial germ cell tumours. Acta Neuropathol 25, 291–306 (1973). https://doi.org/10.1007/BF00691757
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DOI: https://doi.org/10.1007/BF00691757