Clinical analysis of 98 cases of intracranial germinoma

Objective To study the clinical features of intracranial germinoma. Methods Clinical manifestations,imaging characteristics and laboratory test results of 98 intracranial germinoma patients admitted to our hospital in January 1993-August 2009 were retrospectively analyzed. Results Of the 98 intracranial germinoma patients at the age of 2-56 years（mean 17.4±8.31 years）,with a male/female ratio of 1.88:1,26,17,and 46 were from the departments of endocrinology,neurology,neurosurgery,respectively,and 9 from other departments.The patients with their tumor located in the sellar region suffered from diabetes insipidus,hypopituitarism and vision disturbance.The patients with their tumor located in the basal ganglia region presented with hemiplegia and aphasia,while those with their tumor located in the pineal region had intracranial hypertension induced by obstructive hydrocephalus.MRI revealed single or multiple lesions in different parts of the brain with a long or equal T1/T2 signal and a homogeneous or heterogeneous enhancement.The HCG level in spinal fluid（csf）,measured in 31 cases（31.63%）,was 0.17IU/L-5316.98IU/L with a median value of 3.44IU/L.The HCG level was higher than 0.5IU/L in about 90% of the 31 patients with a HCG ratio in csf and serum over 1.78.The HCG level in geminoma located in the pineal region was higher than that located in the basal ganglia region.The HCG level in geminoma located in the sellar region was the lowest.The HCG ratio in csf and serum was 5.46,4.15,and 3.67,respectively,in different parts of the brain,similar to the overall ratio of 4.97. Conclusion The clinical features of intracranial germinoma located in different parts of the brain are quite different.An accurate diagnosis of intracranial germinoma can be established according to its clinical manifestations and MRI characteristics and HCG level.