Intracranial Germ Cell Tumors

GCTs account for 0.3% of all intracranial tumors (see Chapter 21). More than 90% of tumors are found in children and in adolescents younger than 20 years.64 Two-thirds of tumors are found in the second decade. In children, GCTs make up 3% of all intracranial tumors. Intracranial GCTs have their highest incidence in East Asia, accounting for up to 15% of childhood neoplasms in Japan and Taiwan.65 In Western countries, the tumors are 2.5 times more common in males than in females, but in Japan, the male-to-female ratio is 9:1.66

Most intracranial tumors are located in the pineal region, followed by the suprasellar compartment.64 Most tumors are classified as germinomas, accounting for 60% of all intracranial GCTs.65,66 These tumors correspond histologically to testicular semi-nomas, and they are highly radiosensitive. About 10% of intracranial GCTs are benign teratomas. Mixed GCTs, pure ECs, pure yolk sac carcinomas, and choriocarcinomas are equally represented, accounting for the remaining 30% of GCTs.

Intracranial GCTs have the same morphology and share many (if not most) of the molecular biologic features of testicular and ovarian GCTs.67

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