Germinoma of the brain
Germinoma of the brain is a rare tumor that occurs even in the intrauterine development of the fetus, develops from germ leaves, from which organs and tissues of the child are formed during embryogenesis. It can consist of various tissues and form not only in the brain, but also in other parts of the body — the reproductive system, the spine.
The content of the article:
Causes of germinoma of the brain
Symptoms of brain germinoma
Diagnosis of brain germinoma
Treatment of brain germinoma
Prognosis and prevention of brain germinoma
Germinoma of the brain
This type of tumor accounts for only two percent of all neoplasms, but is the most common among deep tumors. Most often, the germinoma of the brain covers the deep structures of the brain and is difficult to operate. The tumor can be either benign or include a teratoma, a tumor of the gallbladder, embryonic cancer and chariocarcinoma.
This neoplasm develops together with a growing organism, in early childhood it may not manifest itself in any way. Usually symptoms are observed in adolescence — in 12-13 years. If the tumor is malignant, it manifests itself earlier. Slowly progressing neoplasms can be dormant even up to twenty-five to thirty years. According to statistics, men are more prone to neoplasm. Often, a brain germinoma is malignant and progresses into the cerebrospinal fluid, surrounding tissues and brain structures. It is localized mainly near the third ventricle. In about a fourth of all cases of brain germinomas, the nature of the neoplasm is benign.
Causes of germinoma of the brain
There is no unambiguous opinion about the cause of the formation of a brain germinoma. Scientists and oncologists are more inclined to the version of a violation in the process of embryogenesis. There is a so-called dysontogenetic theory of the occurrence of this type of tumor. According to this theory, brain germinoma occurs as a result of violations of tissue differentiation and tissue migration at the very first stages of embryogenesis in the first trimester of pregnancy. The basis of this hypothesis is more based on the fact that the neoplasm is more often detected in people at a young age.
Germinoma is usually attributed to the type of embryonic tumors, and these neoplasms arise and develop even before the full formation of the fetus from the rudiments of embryonic tissues. The reason is a violation of embryogenesis, which occurs as a result of changes in the structure of chromosomes and mutations of genes that are entrusted with the control of the normal development of embryogenesis.
Factors that excite changes and disorders in embryogenesis may represent a mediocre or direct effect on the body of the expectant mother. Such provocateurs can be called contact with toxic substances during pregnancy, the influence of radioactive substances, infections of various kinds (measles, herpes, severe stages of influenza). The risk factor will also be the influence of carcinogens.
Symptoms of brain germinoma
The clinical picture of brain germinoma mostly depends on its localization. Localization of germinoma of the brain — deep structures of the brain — the area of the pineal body, the third ventricle.
One of the first signs of this neoplasm will be a violation of blood flow and hydrocephalus as a consequence. Patients often complain of a bursting headache, which is not quenched by analgesics or other painkillers. There is also a feeling of pressure in the eyes, constant nausea, independent of meals, sometimes even vomiting. Visual impairment is often observed. This is due to the fact that the germinoma localizes near the chiasm of the optic nerves and, growing, infringes on them. Patients focus on double vision, visual field defects, farsightedness or myopia.
The clinical picture of brain germinoma is also characterized by deterioration or partial memory loss, mental disorders, emotional instability. In some cases, there may be various kinds of neuroendocrine syndromes like diabetes insipidus, as well as menstrual cycle disorders, anovulation, amenorrhea in women and disorders in the hypothalamic — pituitary system. Disorders of puberty development are also diagnosed. All these symptoms are explained by the localization of the tumor near the hypothalamus.
Diagnosis of brain germinoma
The first diagnostic conclusions are made already at the first examination by a neurologist. Neurological examination and questioning of the patient, his complaints and accents in the characteristics of general well-being makes it possible to establish or assume the presence of hydrocephalus.
Methods of diagnosing brain germinoma:
Echo-enciphalogram. Firstly, it allows you to diagnose intracranial pressure, and secondly, in the case of large neoplasms, when carrying out this diagnostic method, it is possible to detect a displacement of the deep structures of the brain.
Tomographic methods — CT and MRI of the brain. They make it possible to identify the nature of the tumor, localization and size. Almost half of the patients diagnosed with brain germinoma have a tumor infiltration of the visual tubercles and the fact of petrification in the middle (the so-called butterfly symptom) in the clinical picture. In confirmation of this diagnosis, the presence of tumor-like bodies in the lateral ventricles, metastases in the infundibular region of the third ventricle can be said.
Biochemical analysis of blood — the establishment of markers of hCG, ACE, PSCHF.
Steretactic brain biopsy. This method will be the most accurate in making a diagnosis, since a laboratory examination of the tumor body is carried out. In some cases, such a study may not give accurate results — if the neoplasm is heterogeneous.
Morphological examination of tumor sites after its removal. The complexity of this method lies in the localization of neoplasms in the deep structures of the brain, so doctors often prefer stereotactic biopsy.
Germinoma of the brain has a similar clinical picture with a number of neoplasms in the central nervous system, therefore it needs careful diagnosis and differentiation from diseases with similar symptoms. Among such diseases are:
astriocytoma;
glioma;
ganglioneuroma;
hematoblastoma;
medulloblstoma;
brain abscess;
intracerebral hematoma;
cysts in the area of the third ventricle.
Treatment of brain germinoma
Most often, the tactics of treating brain germinoma consists in radiation therapy. If the age of the patients is too small, the general condition does not allow radiation therapy or there are contraindications, then polychemotherapy is prescribed. Sometimes surgical intervention will be a mandatory and forced method of treatment and may be accompanied by radiation or polychemotherapy. But such a comprehensive method of treating this disease is extremely undesirable for young or child patients, as it entails severe intoxication of the entire body.
Surgical intervention
The surgical method of treating brain germinoma can be carried out in various ways and is performed when making an accurate diagnosis and establishing the localization, nature and size of the neoplasm. Often the surgical method of treatment is the only possible one, since other methods will be ineffective. In some cases, surgical intervention requires additional procedures — ventriculocysternostomy or ventriculoperitoneostomy.
Contraindications for the surgical treatment of brain germinoma may be the inoperable location of the tumor or dissenimated growth of the neoplasm, as well as multiple foci. If the size of the tumor is small, it is advisable to use radiosurgery methods. The essence is a single exposure to the location of the neoplasm with a high dose of radiation.
The treatment of the disease is within the competence of specialized departments of neurosurgery, which are equipped with equipment, a computer visualizing system of neuronavigation.
Prognosis and prevention of brain germinoma
The main methods of prevention of germinoma of the brain can be considered the exclusion of any negative impact on the body of the expectant mother. A pregnant woman should lead a healthy lifestyle, avoid contact with radioactive and toxic substances.
This disease, if it is detected in the early stages, responds well to treatment with chemotherapy and radiation therapy. In the future, to control your condition and the course of the disease after treatment, it is necessary to consult a neurologist at least once a year. Even with surgical intervention, the prognosis can be quite encouraging — the survival rate after such operations is approximately 85 percent.
