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Abstract

Neuroimaging of disseminated germ cell neoplasms.

V P Mathews, D R Broome, R R Smith, J R Bognanno, L H Einhorn and M K Edwards
American Journal of Neuroradiology March 1990, 11 (2) 319-324;
V P Mathews
Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
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D R Broome
Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
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R R Smith
Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
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J R Bognanno
Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
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L H Einhorn
Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
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M K Edwards
Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
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Abstract

The purpose of this study was to determine the role of neuroimaging in the management of patients with metastatic germ cell tumors. Retrospective evaluation of 299 patients treated in 1986 and 1987 for initial presentation or recurrence of testicular, retroperitoneal, and mediastinal germ cell tumors was performed to determine indications for neuroimaging, frequency and site of CNS metastases, and occurrence of other CNS abnormalities. Sixty-six patients required CNS imaging with myelography, CT, or MR. Studies were normal in 24 patients. Twenty patients had CNS metastases including 11 with intracranial metastases, eight with spine lesions, and one with both brain and spine involvement. Sixteen had cerebral or cerebellar atrophy of unclear origin and functional significance. Two patients had ventriculomegaly without symptoms of hydrocephalus. Four patients had questionable lesions that were never confirmed. None of the 25 asymptomatic patients with elevated serum tumor markers had brain metastases. Fifteen of 17 patients with focal neurologic deficits and three of six patients with seizures had CNS metastases. CNS imaging to detect germ cell tumor metastases is most useful in the presence of neurologic deficits or seizures but is not useful in patients with unexplained elevation of serum tumor markers in the absence of neurologic deficits.

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American Journal of Neuroradiology
Vol. 11, Issue 2
1 Mar 1990
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Cite this article
V P Mathews, D R Broome, R R Smith, J R Bognanno, L H Einhorn, M K Edwards
Neuroimaging of disseminated germ cell neoplasms.
American Journal of Neuroradiology Mar 1990, 11 (2) 319-324;

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Neuroimaging of disseminated germ cell neoplasms.
V P Mathews, D R Broome, R R Smith, J R Bognanno, L H Einhorn, M K Edwards
American Journal of Neuroradiology Mar 1990, 11 (2) 319-324;
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