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A Primary Spinal Nongerminomatous Germ Cell Tumor With Multiple Intracranial Metastases in a Toddler

Lookup NU author(s): Dr Rebecca Hill, Dr Gail Halliday, Dr Dipayan Mitra, Professor Simon BaileyORCiD

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Abstract

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.Central nervous system germ cell tumors (CNS-GCTs) comprise 4% of all pediatric CNS tumors, with one third being nongerminomatous GCT (CNS-NG-GCT) type. The majority of these tumors arise in the intracranial compartment with 20% having drop metastases in the spine. We present a rare case of a 2-year-old boy with a primary intradural-extramedullary NG-GCT arising from the lumbosacral spine with a trifecta of unfavorable features, that is, young age, alpha-feto protein >1000 ng/mL, and disseminated disease within the cranium. Owing to his young age, he was treated with chemotherapy alone, avoiding radiation. His tumor marker (alpha-feto protein) declined from 8468 to 10 k-U/L over 8 weeks, and he remained in remission at the last follow-up. This atypical presentation of an intradural-extramedullary tumor with cranial dissemination in a childhood NG-GCT has yet to be described in the literature. Here we use this opportunity to highlight the treatment strategies and challenges in this unique clinical case.

Publication metadata

Author(s): Ramanathan S, Hill RM, Ryles J, Halliday G, Mitra D, Bailey S

Publication type: Article

Publication status: Published

Journal: Journal of Pediatric Hematology / Oncology

Year: 2023

Volume: 45

Issue: 3

Pages: e415-e418

Print publication date: 01/04/2023

Acceptance date: 02/04/2022

ISSN (print): 1077-4114

ISSN (electronic): 1536-3678

Publisher: Lippincott Williams & Wilkins

URL: https://doi.org/10.1097/MPH.0000000000002486

DOI: 10.1097/MPH.0000000000002486

PubMed id: 35622992

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