Tumor lesions of the brain - a serious pathology, accompanied by a certain risk, because the brain - the main regulator of all vital organic functions. Therefore, lesions of the cerebrospinal structures lead to dangerous pathological processes. One such disease is germinoma.
What is germinoma?
The cerebrospinal germinoma is primarily a malignant tumor formation of a dissonogenetic type that is located deep in the brain.
In the pituitary gland, germinomas are localized in approximately 25% of patients, and about 56% of cases occur in the pineal region. Usually, such formations appear at 10-20 years of age, and more often the tumor affects men.
These tumors are more often malignant( 75% of cases) and tend to disseminate into neighboring structures and brain tissues.
Disease classification code D43.0.
Causes of
Although there is no unambiguous answer about etiology, most experts claim that cerebrospinal germinoma forms against a backdrop of various abnormalities during embryonic development from embryonic leaflets.
According to the dysontogenetic theory of the origin of germinoma, the tumor arises from the failure of the process of tissue differentiation and their migration in the first months of pregnancy( 1 term).
As the factors that cause pathological changes in the processes of embryonic development, the following reasons are:
- Radioactive effect;
- Contact of a pregnant woman with substances with radiation activity;
- Different kinds of intoxication;
- Carcinogenic effects;
- Infectious pathologies in pregnancy such as severe forms of influenza, herpes and measles, chlamydia, etc.
Germins are referred to as embryonic tumors, since they develop before the final formation of the fetus from embryonic rudiments.
This is due to disturbances in the processes of embryogenesis due to structural chromosomal changes and gene mutations arising against the background of the above-described factors.
Symptoms of the germinoma of the brain
The tumor develops along with the growth of the body and at first does not manifest itself, and the first signs begin to show themselves only to 10-12 years.
If the tumor is characterized by a high degree of malignancy, then it can manifest earlier, as it grows a little faster.
In general, the clinic of the cerebral germinome is caused by its localization, which is represented by the third ventricle or pineal body.
Symptoms of germinoma manifest themselves in the following:
- Intensive streaking headaches;
- Nausea-vomiting syndrome, not associated with food;
- Pressure in the eyes;
- Visual impairments such as double vision, visual impairment, visual field defects, etc.
- Memory disorders;
- Psycho-emotional disorders;
- Deviations in the activity of the pituitary-hypothalamus system;
- Neuroendocrine syndromes present in the form of diabetes of a non-sugar type, menstrual irregularities, painful menstruation or lack thereof;
- Pangypopituitarism, manifested by a delay in the development and growth of children, sexual dysfunction, weakness, weight loss, etc.
Diagnosis
Diagnosis of germinoma is handled by a neuropathologist, from which the procedure for determining the diagnosis begins.
The doctor performs an examination and appoints an additional examination:
- MRI, CT of cerebral structures. These methods determine the nature of education, its parameters and location;
- Echo-encephalography. A similar study reveals the presence of ICP.And at large sizes of a tumor reveals the displacement of deep cerebral structures;
- Biochemical study of blood with the definition of oncomarkers like PTC, AHCH or hCG;Biopsy stereotaxic. The method allows to more accurately determine the structure of the tumor and its nature;
- Morphological diagnosis of tumor sites after surgical removal. The procedure is complex, because the formations are localized in the deep tissues of the brain. Therefore, stereotactic biopsies are more often given preference.
The cerebrospinal germinoma has many similarities with other neoplasms by clinical signs, therefore, along with the traditional diagnosis, a differential one is also performed.
Treatment of tumor
Treatment of the tumor process in the brain is carried out in various ways.
The increased sensitivity of such formations to chemotherapeutic and radiation exposure makes it possible to select these methods of treatment as the basic ones.
The use of radiological therapy is contraindicated in pediatric patients, since such an effect adversely affects the developing brain tissue.
Therefore, small patients are more often treated with antitumor drugs, if the tumor process has a wide prevalence, then polychemotherapy is prescribed.
If the formation is not large, then it is better to use radiosurgical treatment, which assumes a single exposure to a high dose of radiation on the tumor site.
Sometimes chemotherapeutic and radiotherapy is used as an adjunct therapy for surgical treatment. Operative intervention is often the only possible option for treating germinoma.
But the operation for removal has its own contraindications:
- Dissiminated germinome growth;
- Non-operative localization of education;
- Multiple tumor foci.
Operational removal of germinoma is a technically complex neurosurgical and neurological task. The main difficulty is access to the tumor, because it is located deep in the brain.
But fortunately, today, thanks to the presence of neurovisualizing techniques, specialists are able to plan the entire operation in seconds. Therefore, surgical removal of germinoma is the method of choice.
The specific method of removal is selected by the neurosurgeon individually. Removal of a tumor is often supplemented by a shunt operation such as ventriculocysternostomy or ventriculoperineostomy.
Prognosis and prevention of
There are no specific preventive methods against germinoma. It is possible to avoid a tumor by eliminating all sorts of unfavorable factors affecting the maternal organism during pregnancy.
Headache germinomas have relatively positive predictions for any kind of treatment, whether surgical removal or radiation therapy. Although they depend on the operability and histological characteristics of education.