Mixed germ cell tumours of the pineal region

ABSTRACT

Intracranial mixed germ cell tumours, particularly with the occurrence of germinoma and teratoma components, are very rare. On many occasions, the diagnosis is only reached after a second surgical resection of what is believed to be a tumour recurrence. The authors report two young adolescent males who presented with headache, vomiting and Parinaud's syndrome. Cranial CT and MRI scans demonstrated a large heterogeneous pineal region tumour. Through a supracerebellar infratentorial approach, in both patients, a complete excision of the tumour was achieved of a histopathologically proven mixed germ cell tumour, predominantly teratoma with elements of germinoma. The patients received adjuvant chemotherapy and radiotherapy and remained tumour free during their follow-up. The authors discuss the management of this rare entity and emphasize the importance of detailed histopathological examination