CNS Germ Cell Tumors

Malignant germ cell tumors represent approximately 3% of childhood according to cancer registries in North America and Europe (Kaatsch and Grabow 2012). In contrast, these tumors account for approximately 11% of childhood tumors in some Asian countries (Echevarria et al. 2008). The World Health Organization divides intracranial germ cell tumors into pure germinoma and nongerminomatous germ cell tumors (NGGCT). These classifications are prognostic and determine therapeutic interventions, with pure germinomas having a more favorable prognosis and requiring less therapy. Up to 65% of germ cell tumors are classified as pure germinoma and the remaining one-third included NGGCTs (Jennings et al. 1985). NGGCTs include embryonal carcinoma, endodermal sinus tumor (also known as yolk sac tumor), choriocarcinoma, teratoma (immature and mature), and mixed tumors with more than one element. Approximately 25% of NGGCTs are mixed.