Non-gonadal Germinomas

Germinoma is primarily a disease of young males. There are germinomas that arise in the testicles or ovaries, the gonads, and those that do not. It is presumed that the non-testicular germinoma have their origin in germ cells left behind in various places in the body during the development of the fetus. The current World Health Organization classification of Germ Cell Tumors (GCT), which is based primarily on histological elements, divides these tumors into the following major forms: Germinoma – Pure and with syncytiotrophoblasts, constituting 65%, NGGCT(non-gonadal, meaning non-testicular or ovarian)s, Teratoma – Mature and malignant, Embryonal carcinoma, Yolk sac ,  choriocarcinoma, endodermal sinus tumor and mixed, which combines these different elements.

Surgery and radiation are mainstays of treatment. More recently, chemotherapy has been added to the treatment regimens in order to permit the use of a lower radiation dose, thereby reducing the long-term morbidity associated with radiation therapy while maintaining the excellent survival rates. In patients with NG (non-gonadal) GCTs, the use of adjuvant chemotherapy with radiation therapy is intended to improve outcome, because even with surgery and CSI these patients have a poor prognosis. For NGCGT, chemotherapy prolongs survival. As with gonadal germ cell tumors, the agents that have best activity against CNS GCTs are cisplatin, etoposide, vinblastine, bleomycin, and carboplatin. No, but I guess lusted Ifosfamide and cyclophosphamide are also effective. High-dose chemotherapy followed by autologous stem cell transplant may be effective for patients who relapse.

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