Intracranial Germ Cell Tumors

"... a comprehensive, well-organized book dealing with the epidemiology, pathology, diagnosis and treatment of intracranial germ cell tumors. The contributing authors generally succeed in communicating both the broad outlines and the detail of the various aspects covered." Child's Nervous System 2000, vol.16/nr.9 "...an indispensable textbook for all those who care for patients with CNS germ cell tumors." Acta Neurologica Belgica 12/1999

• I. Introduction.- II. WHO histological classification of tumors of the central nervous system (CNS): germ cell tumors (GCTs).- III. Epidemiology of CNS GCTs.- 1. Histological variation and incidence.- 2. Racial and geographical factors.- 3. Age factor.- 4. Gender factor.- 5. Anatomical factor.- 6. Genetic factor.- 7. Other factors.- IV. Pathology.- 1. General features of GCTs.- 2. Germinoma.- 3. Embryonal carcinoma.- 4. Yolk sac tumor (Endodermal sinus tumor).- 5. Choriocarcinoma.- 6. Teratomas.- V. Immunobiology of tumor infiltrating lymphocytes (TIL) in germinomas.- 1. Cell types of germinoma TIL.- 2. The cause and role of immune cell infiltration in germinomas.- 3. Cytotoxicity of TIL to tumor cells.- 4. Conclusive remarks.- VI. Genesis and genetics of intracranial germ cell tumors.- 1. Clonal evolution model for tumorigenesis.- 2. Oncogenes and tumor suppressor genes.- 3. Problematic of ontogenesis of CNS and extracranial GCTs.- 4. Oncogenesis of GCTs.- VII. Clinical findings and diagnosis.- 1. Neurological manifestations.- Radiological diagnosis.- 3. Endocrinological manifestations.- 4. Ophthalmological manifestations.- 5. Tumor markers.- VIII. Prognosis of CNS GCTs.- 1. Survival and recurrence after therapy.- 2. Outcome of patients.- IX. Overview of management.- 1. Classification of CNS GCTs for management.- 2. Diagnosis to select an appropriate treatment mode.- 3. Overview of treatment.- 4. Preliminary results of Japanese Cooperative Study.- X. Surgical management.- 1. Surgical strategy for germinomas.- 2. Surgical approaches to tumours of the pineal region.- Surgical anatomy.- Surgical techniques.- Complications.- 3. Stereotactic biopsy.- XI. Chemotherapy for CNS GCTs.- 1. Overall view of chemotherapy for CNS GCTs.- 2. Chemotherapy for recurrent CNS GCTs.- 3. Chemotherapy for newly-diagnosed CNS GCTs: neoadjuvant chemotherapy.- 4. Chemotherapy - only trials.- 5. Predictors of outcome to treatment.- 6. Myeloablative chemotherapy followed by autologous stem cell rescue for CNS GCTs.- 7. A view of the future.- XII. Radiotherapy for CNS GCTs.- 1. “Diagnostic radiotherapy” or radiation test.- 2. Radiotherapy for CNS germinoma.- 3. Irradiation volume and technique.- 4. Radiotherapy for CNS non-germinomatous GCTs.- 5. Stereotactic irradiation (STI).- 6. Future remarks.- XIII. Adverse effect of therapy and late sequelae in survivors.- 1. Effect of external radiotherapy.- 2. Induction of secondary tumors after irradiation.- 3. Hypothalamic-pituitary dysfunction and their management.- 4. Ototoxicity of chemotherapy.- 5. Clinical significance of pineal gland dysfunction.