Pineal Germinoma: A Common Cerebral Tumor
Our brain is one of the most vital parts of the body. Brain and the central nervous system are interconnected. External action proposes the brain to activate and carry reactionary messages through the connective nerves. Human body movements are controlled by the cerebral nervous system. And this biological and structural functioning of human cerebral system is shattered with disease or infection. Apart from brain injuries and sudden high blood pressure, only biologically inherited syndrome can cause fatal cerebral disease. One of such brain diseases is tumor. Human brain is divided into many regions. The Pineal region is located at the tip of the third ventricle which is made of some fluid filled cavities. The pineal gland has the significant task of secreting melatonin, a hormone which regulates sleep. It also receives signal from the outside environment. Metastasis of the pineal region with tumor formation is rare but holds clinical importance. Pineal Region Neoplasm can be divided into three categories in accordance with the specific cell types. Tumors of the pineal region include both benign pineocytoma and malignant pineoblastoma. There are tumors of the other cells including intra-axial astrocytomas. The germ cell tumors are the commonest ones and it causes Pineal Germinoma.
Location of germinoma and types
Germinomas are the tumor like accumulation seen in the germ cellular pattern inside the cerebral cavity. They are located in both the pineal and suprasellar region. These cells can sometimes be located at the thalamus too. Germinoma is believed to derive its cellular origin from the surrounding areas of the embryo during pregnancy. They are other germ cell tumors too such as embroynal cell carcinoma, endodermal sinus carcinoma, mixed germ cell tumors but these are not common.
Intracranial Germinoma
The occurrence of such germinoma is quite rare but it has prevalence in children. It occurs in the middle line of brain where the space is kept for pineal or suprasellar areas. In the hypothalamic region of the brain, this type of germ cell tumor is found the most. Even the thalamus and basal ganglia can be affected by this kind of tumor. In malignant state, these tumors may spread into the spine and have potential to infect the cerebrospinal fluid causing meningitis in patients.
Risk factors * These kinds of pineal germinomas are seen mostly in children aged between 1-20 years. Almost 3-5% cases of brain tumors in children are caused by germinoma. * The occurrence of such tumors is high in Japan. * Germinomas have been shown to invade and weaken males more than females with an astonishing 9:1 ratio. * Suprasellar germinomas affect males and females equally. * As it is an incurable cerebral condition, the mortality rate among children is higher as they often cannot cope up with the pain and fatality of this slowly progressive disease. * 59% of the patients who are treated with traditional radiation manage to survive for 5 years. * Drug treatment can increase life expectancy as much as 81% in younger adults only if it is case of very indolently growing germinomas.

Symptoms * Germinomas can create a rare syndrome called Parinaud syndrome which is actually the result of the compression of tectum. People with growing germ cell tumors often come up with symptoms of this syndrome. * Patients may encounter seizures and frequent headache the severity of which fluctuates with time and is dependant of the extent of growth of the tumor. * Inconsistency in looking upward or difficulty in looking downward may happen with such cerebral condition. * Patients experience black out and color discoloration. * They gradually lose the ability to interact normally in social places. Their perceptual abilities become limited. * They often lack co ordination and speak words with little meaning or no sense. * There might be total collapse of the neurological functioning and paralysis may occur followed by cerebral thrombosis. * It can cause precocious puberty in male children.
Diagnosis and Treatment
CT scanning is always helpful to see and analyze the size and location of tumor. In case of progressive tumors, MRI can detect the actual position. If germ cell malignancy is suspected, doctors may perform a cerebrospinal fluid testing through which the presence of germ cells can be detected. The examiner may look for human chorionic gonadotropin or beta-HCG and alpha feto protein (AFT) because this protein and hormone are produced by germ cells. If an elevation of level is found, further diagnosis process becomes easy. This might show the involvement of central nervous system as well. Biopsy is sometimes done when the cellular type of the tumor cannot be determined. The treatment always includes surgery with an attempt to remove the tumor as much as possible. In case of metastasis, radiation or chemotherapy injection can be provided for the prevention of growth followed by surgery.
Radiation works best to combat germinomas. Supportive care along with effective treatment can improve the quality of life.