Germ Cell Tumors of the Central Nervous System

Germinomas account for about 3% of pediatric intracranial tumors

65% of all CNS germ cell tumors

Twice as common in East Asia and Japan as in the United States

Male predominance

Males in late teens or early 20s in the pineal gland region—most common

Headaches caused by progressive hydrocephalus and intracranial hypertension from pineal region tumors obstructing the cerebral aqueduct

Parinaud syndrome (paralysis of upward gaze and convergence) may be seen with tumors that compress or invade the tectal plate

Suprasellar region less common: symptoms include visual field defects, diabetes insipidus, pituitary failure, and delayed growth and sexual maturation (tumors that disrupt the hypothalamic/pituitary axis)

Germinomas are radiosensitive: 10-year survival rate of 85% or greater

Prognosis not as good with mixed germ cell tumors

Germinomas are hyperdense, enhancing lesions of the pineal or suprasellar region