Germinoma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Symptoms

Clinical presentation is mainly related to the location and size of the tumor and the patient`s age. Endocrine abnormalities, headache, vomiting, and visual changes are among the most common symptoms. Many patients with unrecognized CNS GCTs may have had a long history of symptoms such as movement disorders, enuresis, anorexia, and psychiatric complaints. Diagnosis in such cases has been delayed from 7 months to 3 years. Presenting symptoms of patients with intracranial GCTs depend upon the location of the tumor. Delays in diagnosis are common, especially symptoms related to endocrinopathy (delayed vertical growth, diabetes insipidus, etc.) are associated with delays of greater than 12 months, and are associated with higher incidences of disseminated disease [19].

TYpe of the tumor	Symptoms
Pineal tumors	Obstructive hydrocephalus In approximately 25 to 50 percent of cases symptoms of increased intracranial pressure are present, which include the following: Headache Vomiting Papilledema Lethargy Somnolence Other symptoms associated with pineal germ cell tumors (GCTs) and obstructive hydrocephalus include the following: Ataxia Behavioral changes Decline in academic performance Neuroopthalmologic abnormalities are present in approximately 50 percent of cases Paralysis of upward gaze Paralysis of convergence Endocrinopathies are rarely associated with pineal tumors, although diabetes insipidus is sometimes observed which may indicate occult tumor involvement of the floor of the fourth ventricle and the suprasellar area
Suprasellar tumors	In majority of cases suprasellar germ cell tumors GCTs are commonly present with hypothalamic/pituitary dysfunctions which include the following: Diabetes insipidus Delayed pubertal development Precocious puberty Isolated growth hormone deficiency Hypopituitarism (central hypothyroidism, adrenal insufficiency) Suprasellar germ cell tumors GCTs can also cause ophthalmologic abnormalities such as: Decreased visual acuity from chiasmic or optic nerve compression Visual field deficit (e.g, bitemporal hemianopsia) In majority of cases patients with suprasellar GCTs have chronic subtle symptoms, and their tumors are diagnosed incidentally on imaging studies performed for unrelated reasons.

References

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