Primary intracranial germ cell tumors: A single institution experience from a South Indian tertiary cancer center

Background: Intracranial germ cell tumors (ICGCTs) are rare tumors seen in the pineal and suprasellar regions. The World Health Organization has classified ICGCTs into germinoma and nongerminomatous GCT (NGGCT). Germinoma is radiosensitive and has excellent survival rate. Patients with NGGCTs are less sensitive to radiotherapy and have less favorable outcome. Objective: This retrospective observational study was carried out to determine the clinical features, treatment, and outcome of patients diagnosed as ICGCT from June 2006 to June 2014.Materials and Methods: Patients' medical records were reviewed for information regarding age, gender, presenting features, treatment instituted, complications, and treatment outcome. Results: Seven patients with ICGCT were studied. Their age ranged from 4 to 24 years, with median age being 13 years. All of them were male. Four patients had germinoma and three had mixed NGGCT. Four patients had pineal region mass, two patients had suprasellar mass, and one patient had bifocal disease with both pineal and suprasellar involvements. Following surgical debulking or ventriculoperitoneal shunt, patients received radiation and chemotherapy. One patient of germinoma and another patient of NGGCT died due to febrile neutropenia/sepsis. The overall survival was 4 years for patients with both germinoma and NGGCT. Conclusions: ICGCTs are rare tumors seen in the second decade of life, with male preponderance. With judicious use of chemotherapy and radiotherapy, germinoma has excellent survival outcome. The outcome of NGGCT can be improved with multimodality treatment.