Pineal germinoma morphological features in a liquid-based cerebrospinal fluid sample

Germ cell tumors are a group of neoplasms both benign (mature teratomas) and malignant (germinomas and nongerminomas) that occur in midline locations including the gonads, the mediastinum, the retroperitoneum, and the central nervous system. The central nervous system is the second most common site of extragonadal germ cell tumors after the mediastinum. Primary intracranial germ cell tumors typically occur in the pineal or suprasellar region in children and adolescents. They are more frequent in Asia where they account for up to 10% of all central nervous system malignancies. Among germ cell tumors, germinoma is the most common. It tends to spread via the cerebrospinal fluid. Therefore, the diagnostic algorithm also includes the cytological examination of the cerebrospinal fluid. Cerebrospinal fluid analysis is important for staging and for planning therapy. Germinomas are extremely chemo and radiosensitive and have an excellent overall survival rate.