{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:05:48Z","timestamp":1785438348722,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study analysed the clinical features of a cohort of children with intracranial germ cell tumours (IC\u2010GCTs). We retrospectively reviewed timelag between symptoms onset, clinic\u2010radiological findings, diagnosis and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Symptoms at diagnosis were divided into four groups: (1) raised intracranial pressure (RICP); (2) visual impairment; (3) endocrinopathies; (4) other. Total diagnostic interval (TDI), defined as the interval between symptom onset (including retrospective recall of symptoms) and definitive diagnosis of IC\u2010GCT, was calculated and compared to survival rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our cohort included 55 children with median follow\u2010up of 78.9 months (0.5\u2013249.9). The majority (63.6%) had germinomas and 10.9% were metastatic at diagnosis. IC\u2010GCTs were suprasellar (41.8%), pineal (36.4%), bifocal (12.7%) or in atypical sites (9.1%). The most common presenting symptoms were related to RICP (43.6%); however, by the time of tumour diagnosis, 50.9% of patients had developed endocrine dysfunctions. All pineal GCTs manifested with RICP or visual impairment. All suprasellar GCTs presented with endocrinopathies. TDI ranged between 0.25 and 58.5 months (median 4 months). Pineal GCTs had the shortest TDI (median TDI 1 month versus 24 months in suprasellar GCTs, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). TDI\u00a0&gt;\u00a06 months was observed in 47.3% of patients and was significantly associated with endocrine presenting symptoms. No statistically significant difference was found in progression\u2010free survival and overall survival between patients with TDI\u00a0&gt;\u00a06 months and with TDI\u00a0\u2264\u00a06 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Approximately half of the IC\u2010GCT patients in this cohort had TDI\u00a0&gt;\u00a06 months. These presented mostly with endocrine deficits. TDI\u00a0&gt;\u00a06 months was not associated with increased relapse or mortality rates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30168","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T06:15:35Z","timestamp":1672380935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Implications of deferred diagnosis of paediatric intracranial germ cell tumours"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3714-6508","authenticated-orcid":false,"given":"Cristina","family":"Partenope","sequence":"first","affiliation":[{"name":"Department of Pediatrics IRCCS San Raffaele Scientific Institute  Milan Italy"},{"name":"Department of Paediatric Endocrinology Royal Marsden NHS Foundation Trust  London 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