Journal of neuro-oncology · 2026
Intracranial germ cell tumors: an underrecognized diagnostic consideration in adults with sellar/suprasellar lesions.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Shirui, Zhen Yining, Yao Yong, Duan Lian, Lian Xin, Wang Linjie, Chen Shi, Pan Hui, Lu Lin, Gong Fengying, Deng Kan, Zhang Yi, Xing Bing, You Hui, Feng Feng, Mao Xinxin, Li Xiaoyuan, Zhu Huijuan
Аннотация
PURPOSE: Sellar/suprasellar intracranial germ cell tumors (iGCTs) predominantly occur in children and adolescents, while adult-onset cases are rare and poorly characterized. We aimed to characterize adult-onset iGCTs and improve their differential diagnosis.
METHODS: Patients with iGCTs and onset age ≥ 18 years were enrolled in a single center. Adult-onset LYH patients served as comparison. iGCT and LYH were diagnosed using predefined pathological or clinical criteria incorporating characteristic clinical presentations, laboratory findings, MRI features, and treatment response. A nomogram was developed to distinguish iGCTs from LYH and was internally validated using 1,000 bootstrap resamples.
RESULTS: Forty-eight adult patients with iGCTs were enrolled, including 36 with germinoma and 12 with nongerminomatous germ cell tumors. The median age at onset was 23.4 years (range 18.1-53.5), and 87.5% were male. Forty-six patients with LYH were included for comparison. CSF β-hCG accurately diagnosed iGCTs from LYH (AUC 0.897, 95% CI 0.821-0.973). The optimal cutoff was 2.52 U/L, yielding a sensitivity of 78.6% and a specificity of 95.5%. The nomogram incorporating sex, log-transformed serum β-hCG, hyperprolactinemia, and pituitary stalk thickening differentiated iGCTs from LYH with an AUC of 0.939 (95% CI 0.875-1.000). Among patients with documented treatment regimens, 17 (53.1%) underwent radiotherapy, and 15 (46.9%) received chemoradiotherapy. During a median follow-up of 1.7 years (range 0.2-13.5), four patients developed progression or recurrence.
CONCLUSIONS: iGCT represents a rare yet possible etiology of suprasellar/sellar lesions in adults. CSF β-hCG and the proposed nomogram may aid differential diagnosis, although external validation in independent cohorts is still required.
METHODS: Patients with iGCTs and onset age ≥ 18 years were enrolled in a single center. Adult-onset LYH patients served as comparison. iGCT and LYH were diagnosed using predefined pathological or clinical criteria incorporating characteristic clinical presentations, laboratory findings, MRI features, and treatment response. A nomogram was developed to distinguish iGCTs from LYH and was internally validated using 1,000 bootstrap resamples.
RESULTS: Forty-eight adult patients with iGCTs were enrolled, including 36 with germinoma and 12 with nongerminomatous germ cell tumors. The median age at onset was 23.4 years (range 18.1-53.5), and 87.5% were male. Forty-six patients with LYH were included for comparison. CSF β-hCG accurately diagnosed iGCTs from LYH (AUC 0.897, 95% CI 0.821-0.973). The optimal cutoff was 2.52 U/L, yielding a sensitivity of 78.6% and a specificity of 95.5%. The nomogram incorporating sex, log-transformed serum β-hCG, hyperprolactinemia, and pituitary stalk thickening differentiated iGCTs from LYH with an AUC of 0.939 (95% CI 0.875-1.000). Among patients with documented treatment regimens, 17 (53.1%) underwent radiotherapy, and 15 (46.9%) received chemoradiotherapy. During a median follow-up of 1.7 years (range 0.2-13.5), four patients developed progression or recurrence.
CONCLUSIONS: iGCT represents a rare yet possible etiology of suprasellar/sellar lesions in adults. CSF β-hCG and the proposed nomogram may aid differential diagnosis, although external validation in independent cohorts is still required.