60 cases of histologically verified pinealoma of the two-cell-pattern type (the so-called germinoma) experienced from 1962 to 1979 were submitted to direct surgery (by occipital transtentorial approach or infratentorial supracerebellar approach in case of tumors in the pineal region and subfrontal approach in cases of suprasellar tumors) and postoperative irradiation. Locations of tumors were 32 in the pineal region, 20 in the suprasellar region, and 8 in other areas. There was no operative mortality. The postoperative survival rates (the observed survival rates) of these cases were as follows: the 1-year survival rate (1 YSR) was 94.8%, the 5-year survival rate (5 YSR) was 74.8% and 10-year survival rate (10 YSR) was 69.3%. As for pinealomas in the pineal region, 1 YSR was 93.5%, 5 YSR was 64.7% and 10 YSR was 60.1 %; for tumors in the suprasellar region, 1 YSR was 100%, 5 YSR was 100% and 10 YSR was 92.3%. In cases aged from 15 years up, 1 YSR was 93.7%, 5 YSR was 65.0% and 10 YSR was 60.2%, and in cases under 15 years (children), 1 YSR was 95.1%, 5 YSR was 86.9% and 10 YSR was 86.9%. Thus, the results were much better in suprasellar germinoma cases than in pineal cases and in children than in adolescents and adults. Suprasellar germinoma cases under 15 years showed 100%in 1 YSR, 5 YSR and 10 YSR. The reason for this is probably that surgical removal of tumors or reduction of the bulk of tumors may be easier or more extensive in suprasellar germinomas than in pineal germinomas. Among these 60 cases, 2 died of recurrence of tumor, 3 died of dissemination metastases in the cerebrospinal fluid space and the other 11 died of other diseases or due to unknown cause. Besides these 60 cases, 10 cases of probable pinealomas (germinomas) were treated by irradiation without direct surgery. Among these, 1 case died 3 years and 1 month later and 1 case had recurrence and was irradiated again. Most of these cases were experienced in the past 2 years and the follow-up was not long enough. All these cases had rather small tumors, single or multiple. The histogenesis of the tumor and the causes of its radiosensitivity are discussed.

Keywords:
Germinoma, Pinealoma, Follow-up results, Radiotherapy, Surgery, Pineal tumor
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© 1981 S. Karger AG, Basel
1981
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