Germinoma natural history

Revision as of 19:52, 12 February 2016 by Simrat Sarai (talk | contribs)
Jump to navigation Jump to search

Germinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Germinoma from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Germinoma natural history On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Germinoma natural history

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA onGerminoma natural history

CDC on Germinoma natural history

Germinoma natural history in the news

on Germinoma natural history

Directions to Hospitals Treating Germinoma

Risk calculators and risk factors for Germinoma natural history

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Natural history

  • Malignant transformation of primordial germ cells that inappropriately migrated during development (either failing to migrate into or out of an area) are the originators of germinomas. There is no histologic differentiation whereas nongerminomatous germ cell tumors display a variety of differentiation.

Complications

  • Patients with intracranial tumors located in the basal ganglia perform poorly compared with those who have tumors in the suprasellar and pineal regions; they have lower short-term retention of visual and verbal stimuli and full-scale IQs.
  • Larger irradiation volume and dose effect the following functions of the brain adversely:
    • Intellectual functions
    • Concept
    • Executive function
    • Memory
    • Decline in neurocognitive function, and performance IQs
  • Approximately more than 50% of patients may continue to suffer from endocrine abnormalities such as growth hormone deficiency, growth retardation, hypopituitarism, and hypothyroidism, and may require lifelong hormonal replacement therapy
  • Due to surgical resection of tumor or due surgical biopsies the following complications may occur:
    • Poor performance in psychosocial skills
    • Behavioral dysfunction
    • Financial difficulties
    • Lower KPS scores following surgery have been associated with impaired neurocognitive function
  • Complications related to chemotherapy may develop
  • The surgical morbidity associated with pineal-region tumors is approximately 2-5%. Patients may suffer from the following:
    • Transient movement abnormalities of eyes
    • Ataxia
    • Cognitive dysfunction
  • The other complications that may present in patients with intracranial germ cell tumors are following:
    • Brain atrophy
    • Multifocal encephalomalacia
    • Leukoencephalopathy
    • Focal necrosis
    • Cerebrovascular occlusion
  • The incidence of secondary cancer is approximately 6%, in patients with intracranial tumors. The risk of death due to malignancy is approximately 16%. Radiation therapy and chemotherapy may both promote the development of secondary cancers such as acute myeloid leukemia and radiation-induced brain neoplasms.

Prognosis

  • Generally, germinomas are associated with an excellent prognosis. Intracranial germinomas have a reported 90% survival to five years after diagnosis.[1]The 10-year survival of germinomas is 70%.

The prognosis of various germ cell tumors is shown below in a tabular form:

Type of tumor 5-year survival rate
Germinoma
  • 70-90%
Mixed germ cell tumors
  • 60-80%
Nongerminomatous germ cell tumors
  • 30-50%


References

  1. Packer RJ, Cohen BH, Cooney K, Coney K (2000). "Intracranial germ cell tumors". Oncologist. 5 (4): 312–20. PMID 10964999.


Template:WikiDoc Sources