𝔖 Bobbio Scriptorium
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Treatment of a primary intracranial germ cell tumor with systemic chemotherapy

✍ Scribed by Kirshner, Jeffrey J. ;Ginsberg, Sandra J. ;Fitzpatrick, Alicia V. ;Comis, Robert L.

Publisher
John Wiley and Sons
Year
1981
Tongue
English
Weight
634 KB
Volume
9
Category
Article
ISSN
0098-1532

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✦ Synopsis

Abstract

Primary germ cell neoplasms of the central nervous system (CNS) are rare tumors which generally respond to radiotherapy. Experience is limited in managing the refractory patient. We report a patient whose suprasellar dysgerminoma responded completely to 5,000 rad. Seven years later, disease recurrence was refractory to an additional 4,000 rad. Theorizing that the β€œblood‐brain barrier” was no longer intact after extensive radiotherapy and tumor involvement of the ventricular system, the patient was treated with systemic bleomycin, cisplatin, and vinblastine. Pharmacokinetic studies revealed that the bleomycin and cisplatin entered the cerebrospinal fluid. Serial CT scans and CSF levels of β‐HCG confirmed the clinical impression of a partial remission. Subsequent tumor progression was refractory to therapy with intraventricular bleomycin. It is concluded that systemic chemotherapy may be beneficial in certain cases of CNS germ cell neoplasms.

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