Abstract:

Objective To investigate the effects of microneurosurgery combined with radiotherapy in the treatment of giant germinoma in basal ganglia area. Methods The clinical data of 12 patients with giant germinoma in basal ganglia area were collected. All patients underwent total resection of tumors under microscope. The diagnosis was confirmed by pathological examinations after operation, and the characteristic findings in immunohistochemical detection were retrospectively analysed. Radiotherapy was performed 5 to 7 d after operation, with whole brain irradiation 30 Gy+local irradiation 20 Gy+whole spine irradiation 30 Gy. The changes of clinical symptoms and imaging features after operation and the results of immunohistochemical detection for tumors were observed. Patients were followed up for one year, the  quality of life was evaluated with Karnofsky scoring method, and was compared with that before operation. Results Immunohistochemical staining after operation revealed that placental alk phosphatase was positively stained in cytoplasm, and CD117 was positively stained in cytomembrane and/or cytoplasm. After treatment, the symptoms of intracranial hypertension significantly relieved or disappeared, and the clinical signs and symptoms were significant improved in all the patients. CT and magnetic resonance imaging indicated that total resection of tumors was achieved, and the space-occupying effect was significantly relieved. The quality of life evaluated by Karnofsky scoring method was much better than that before operation. Conclusion Microneurosurgery combined with radiotherapy should be the first scheme in the treatment of giant germinoma in basal ganglia area.

Key words: germinoma, microneurosurgery, radiotherapy