Germ Cell Tumors

A group of rare and malignant intracranial tumors arise from germ cell nests displaced during embryogenesis. Histologically, these cells are analogous to the gonadal germ cells. The group includes the germinomas, terato-mas, embryonal carcinomas, endodermal sinus tumors, and choriocarcinomas.

Germ cell tumors commonly occur in children and adolescents and are preferentially situated in the pineal and suprasellar regions. They tend to disseminate along the CSF pathways and seldom metastasize extracrani-ally via the bloodstream.

Pineal region tumors present with signs and symptoms of increased ICP, vertical gaze palsy, and hypotha-lamic and endocrine disturbances. Tumors in the suprasellar region produce diabetes insipidous, visual impairment, and hypopituitarism. On T1-weighted MR images, they appear isointense and densely enhanced with contrast. Elevated serum levels of a-fetoprotein and human chorionic gonadotropin complement the diagnosis.

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