Suprasellar germinomas (ectopic pinealomas): Aspects of immunological characterization and successful chemotherapeutic responses in recurrent disease

Two patients with suprasellar germinomas were initially treated successfully with radiotherapy, but subsequently they developed recurrent tumor 2 1/2 and 12 years later. The recurrent tumor was solely extraneural in the first patient because of seeding from a ventriculoperitoneal shunt, and in the second patient the tumor recurred at its initial site as well as in the 4th ventricle. Both tumors secreted the β-subunit of human chorionic gonadotropin. A dramatic tumor response was seen in both patients with systemic chemotherapy consisting of a combination of cis-platinum, bleomycin, and vinblastine. The 'small cells' in one of the suprasellar germinomas were shown to be predominately T lymphocytes on the basis of an examination of the cell surface markers on these cells.