Intracranial Embryonal Carcinoma mixed with Endodermal Sinus Tumor and Teratomatous Elements in the Anterior Third Ventricle

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  • IWASAKI Isao
    First Department of Pathology, School of Medicine, Chiba University
  • HORIE Hiroshi
    First Department of Pathology, School of Medicine, Chiba University
  • YU Ten Jun
    First Department of Pathology, School of Medicine, Chiba University
  • ARIGA Naobumi
    Departments of Neurosurgery, Matsudo Municipal Hospital
  • OHWADA Tetsuo
    Departments of Neurosurgery, Matsudo Municipal Hospital
  • OKA Yoichi
    Departments of Neurosurgery, Matsudo Municipal Hospital
  • ASANUMA Katsumi
    Departments of Pathology, Matsudo Municipal Hospital

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タイトル別名
  • —Case Report—

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A 16-year-old male patient was diagnosed as having an intracranial germ cell tumor in the anterior third ventricle. Surgery revealed that the tumor was composed of embryonal carcinoma, endodermal sinus tumor, and teratomatous elements, such as cartilage, myogenic tissue, and keratinizing squamous epithelium. Alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) were elevated in the serum preoperatively and demonstrated also in the excised tumor tissue by the immunohistochemical method. After postoperative radiation therapy, the serum AFP and HCG returned to normal limits. About 1 year after the first operation, a recurrence of the tumor, with marked elevation of serum AFP, was detected. A second operation was performed, and the histological examination showed mostly endodermal sinus tumor with irradiation effect and teratomatous elements. The embryonal carcinoma portion had almost disappeared as a result of the earlier radiation therapy. Changes in the tumor composition correlated with changes in serum tumor markers. The patient is being followed closely.

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