Suprasellar germinomas (ectopic pinealomas): aspects of immunological characterization and successful chemotherapeutic responses in recurrent disease.

Two patients with suprasellar germinomas were initially treated successfully with radiotherapy, but subsequently they developed recurrent tumor 2 1/2 and 12 years later. The recurrent tumor was solely extraneural in the first patient because of seeding from a ventriculoperitoneal shunt, and in the second patient the tumor recurred as its initial site as well as in the 4th ventricle. Both tumors secreted the beta-subunit of human chorionic gondadotropin. A dramatic tumor response was seen in both patients with systemic chemotherapy consisting of a combination of cis-platinum, bleomycin, and vinblastine. The "small cells" in one of the suprasellar germinomas were shown to be predominately T lymphocytes on the basis of an examination of the cell surface markers on these cells. (Neurosurgery, 7: 352-358, 1980).