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Primary medulla oblongata germinomas: two case reports and review of the literature.

Hao S, Li D, Feng J, Wang L, Wu Z, Zhang J, Zhang L - World J Surg Oncol (2013)

Bottom Line: A preoperative diagnosis of medulla oblongata germinoma is difficult because of the lack of specific clinical signs and symptoms.If the correct diagnosis is reached, patients can have a favorable prognosis with proper evaluation and treatment.An invasive operation can potentially lesion and impair the function of the medulla oblongata, which is fatal to the patient.

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Affiliation: Department Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, NO,6 Tiantan Xili Dongcheng district, Beijing 100050, P R China. zhangliweittyy@aliyun.com.

ABSTRACT
An intracranial germinoma is a tumor that is sensitive to radiotherapy. As medulla oblongata germinomas are extremely rare, determining an accurate preoperative diagnosis is challenging. Two cases of medulla oblongata lesions were surgically treated, and a postoperative diagnosis of germinoma was determined in both of the cases. The tumor in one patient completely resolved after a treatment course consisting of surgical intervention, radiotherapy and chemotherapy; the other patient, who did not receive any type of adjuvant treatment after surgery, suffered from tumor relapse and died from pneumonia 8 months following surgery. A preoperative diagnosis of medulla oblongata germinoma is difficult because of the lack of specific clinical signs and symptoms. If the correct diagnosis is reached, patients can have a favorable prognosis with proper evaluation and treatment. An invasive operation can potentially lesion and impair the function of the medulla oblongata, which is fatal to the patient.

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Pathological results of the specimen. Histopathological analyses reveal large spheroidal cells with oval nuclei (H&E, ×100) (A). Under transmission electron microscope, the nucleolus of some tumor cells were prominent (arrowhead) and lymphocytes were found scattered between tumor cells (*) (B).
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Figure 2: Pathological results of the specimen. Histopathological analyses reveal large spheroidal cells with oval nuclei (H&E, ×100) (A). Under transmission electron microscope, the nucleolus of some tumor cells were prominent (arrowhead) and lymphocytes were found scattered between tumor cells (*) (B).

Mentions: The postoperative course was uneventful except for transient dysphagia. The histopathological analysis confirmed the diagnosis of germinoma (Figure 2). The patient was treated by gamma knife and subsequently started on two rounds of PEB (cisplafin, etoposide and bleomycin) chemotherapy. The patient returned to school 3 months after surgery (Figure 3). He was followed up for 4 years and has not experienced any tumor recurrence.


Primary medulla oblongata germinomas: two case reports and review of the literature.

Hao S, Li D, Feng J, Wang L, Wu Z, Zhang J, Zhang L - World J Surg Oncol (2013)

Pathological results of the specimen. Histopathological analyses reveal large spheroidal cells with oval nuclei (H&E, ×100) (A). Under transmission electron microscope, the nucleolus of some tumor cells were prominent (arrowhead) and lymphocytes were found scattered between tumor cells (*) (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852531&req=5

Figure 2: Pathological results of the specimen. Histopathological analyses reveal large spheroidal cells with oval nuclei (H&E, ×100) (A). Under transmission electron microscope, the nucleolus of some tumor cells were prominent (arrowhead) and lymphocytes were found scattered between tumor cells (*) (B).
Mentions: The postoperative course was uneventful except for transient dysphagia. The histopathological analysis confirmed the diagnosis of germinoma (Figure 2). The patient was treated by gamma knife and subsequently started on two rounds of PEB (cisplafin, etoposide and bleomycin) chemotherapy. The patient returned to school 3 months after surgery (Figure 3). He was followed up for 4 years and has not experienced any tumor recurrence.

Bottom Line: A preoperative diagnosis of medulla oblongata germinoma is difficult because of the lack of specific clinical signs and symptoms.If the correct diagnosis is reached, patients can have a favorable prognosis with proper evaluation and treatment.An invasive operation can potentially lesion and impair the function of the medulla oblongata, which is fatal to the patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, NO,6 Tiantan Xili Dongcheng district, Beijing 100050, P R China. zhangliweittyy@aliyun.com.

ABSTRACT
An intracranial germinoma is a tumor that is sensitive to radiotherapy. As medulla oblongata germinomas are extremely rare, determining an accurate preoperative diagnosis is challenging. Two cases of medulla oblongata lesions were surgically treated, and a postoperative diagnosis of germinoma was determined in both of the cases. The tumor in one patient completely resolved after a treatment course consisting of surgical intervention, radiotherapy and chemotherapy; the other patient, who did not receive any type of adjuvant treatment after surgery, suffered from tumor relapse and died from pneumonia 8 months following surgery. A preoperative diagnosis of medulla oblongata germinoma is difficult because of the lack of specific clinical signs and symptoms. If the correct diagnosis is reached, patients can have a favorable prognosis with proper evaluation and treatment. An invasive operation can potentially lesion and impair the function of the medulla oblongata, which is fatal to the patient.

Show MeSH
Related in: MedlinePlus