Background
Diagnosis of intracranial germ cell tumours (IC-GCTs) occurs predominantly in children with peak incidence during the second decade of life 1-3.
The two most frequent brain locations are the pineal gland and the suprasellar region or both sites simultaneously (“bifocal disease”). IC-GCTs can also arise in the basal ganglia, thalamus, cerebral hemisphere, and cerebellum 4,5.
According to the WHO classification system, IC-GCTs are divided into germinomas (GTs) and non-germinomatous (NGGCTs) 6. Germinomas comprise 60-65% of all paediatric IC-GCTs. IC-GCTs can also be divided into ”secreting” and ”non-secreting” tumours based on the presence of tumour markers measured in the cerebral spinal fluid (CSF) and/or serum: alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG) 7.
Different CT and RT treatment regimens have been developed in Western Countries 8-11 and in Japan12according to histology and prognosis. Intracranial germinomas have an excellent overall survival (OS) >90%, whereas the prognosis for patients with recurrent IC-NGGCTs is poor13,14.