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A germinoma is a type of germ cell tumor[1] which is not differentiated upon examination.[2] It may be benign or malignant.
The term germinoma most often has referred to a tumor in the brain that has a histology identical to two other tumors: dysgerminoma in the ovary and seminoma in the testis.[3] Since 1994, MeSH has defined germinoma as “a malignant neoplasm of the germinal tissue of the gonads; mediastinum; or pineal region”[4] and within its scope included both dysgerminoma and seminoma. Collectively, these are the seminomatous or germinomatous tumors.
Malignant transformation of primordial germ cells that inappropriately migrated during development (either failing to migrate into or out of an area) are the originators of germinomas. There is no histologic differentiation whereas nongerminomatous germ cell tumors display a variety of differentiation.
The tumor is uniform in appearance, consisting of large, round cells with vesicular nuclei and clear or finely granular cytoplasm that is eosinophilic.
On gross examination, the external surface is smooth and bosselated (knobby), and the interior is soft, fleshy and either cream-coloured, gray, pink or tan. Microscopic examination typically reveals uniform cells that resemble primordial germ cells. Typically, the stroma contains lymphocytes and about 20% of patients have sarcoid-like granulomas.
Metastasis has been noted in approximately 22% of cases at time of diagnosis. Males are approximately twice as commonly affected in developing germinomas. Germinomas are most commonly diagnosed between the age of 10 and 21.
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