ABSTRACT
Germinoma is the most common type of intracranial germ cell tumors (GCTs). Pineal gland and suprasellar region are the most frequent sites of central nervous system (CNS) involvement. Intracranial masses caused by Langerhans cell histiocytosis (LCH) mimics features of CNS GCTs. LCH frequently involve spine and is the most common cause of vertebra plana in children. A 15-year-old boy presented with progressing symptoms of polydipsia, polyuria, general headache, nausea and severe back pain. Brain MRI showed brain tumor with simultaneous involvement of suprasellar region and pineal gland. An excisional biopsy of suprasellar mass was done. The pathologic assessment confirmed the diagnosis of germinoma. Patient's treatment continued accordingly. A spine MRI, done due to persistent backache, showed a vertebra plana. We reevaluated the primary diagnosis suspecting LCH. Germinoma of CNS was confirmed and a biopsy of vertebral lesion resulted in hemangioma. Thus we report a case of CNS germinoma with co-occurrence of vertebra plana. We emphasized the importance of histopathologic diagnosis of pineal/suprasellar masses and primary investigation of other CNS regions including spine for possible metastasis or comorbidities.
Subject(s)
Adolescent , Child , Humans , Male , Back Pain , Biopsy , Brain , Brain Neoplasms , Central Nervous System , Comorbidity , Diagnosis , Germinoma , Headache , Hemangioma , Histiocytosis, Langerhans-Cell , Magnetic Resonance Imaging , Nausea , Neoplasm Metastasis , Neoplasms, Germ Cell and Embryonal , Pineal Gland , Polydipsia , Polyuria , SpineABSTRACT
Background and Aim: the most common primary brain tumors of the central nervous system are gliomas. Among a number of different biomolecular events, a strong relation between oxidative stress pathways and the development of this cancer has been proved. Oxidative stress [OS] is the consequence of an imbalance between pro-oxidants and antioxidants towards pro-oxidants. The pro-oxidants cause lipid peroxidation of cell membranes, protein, DNA oxidation and changes in brain cell growth. In this study, the pro-oxidant-antioxidant balance [PAB] was determined in patients with gliomas
Methods and Materials/Patients: sera of 49 patients with high grade glioma [grade IV WHO] which is called glioblastoma multiform [GBM] and 49 healthy subjects were collected and PAB test was measured
Results: a significant increase of PAB value was observed in patients with GBM [158.10+/-85.71 HK unit] in comparison to control group [74.54+/-33.54 HK]
Conclusion: the PAB assay showed the oxidative stress in glioblastoma. In further research, this easy elucidation of oxidative stress in these patients can be applied to evaluate the effectiveness of antioxidant therapies in patients with GBM