{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:22:34Z","timestamp":1770351754527,"version":"3.49.0"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Bifocal germ cell tumors, with primarily identical tissue composition, occur concurrently in the neurohypophyseal and pineal regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 16-year-old male patient exhibited increased intracranial pressure symptoms, with concurrent tumors in the pineal and neurohypophyseal regions, causing obstructive hydrocephalus. His serum human chorionic gonadotropin level was elevated, measuring 506.6 mIU\/mL. Upon gross endoscopic examination, the pineal tumor appeared white, whereas the neurohypophyseal tumor appeared red and hemorrhagic. Because of the limited sample size of the latter, a frozen section biopsy was feasible only for the pineal lesion, which indicated the presence of a germinoma. Subsequently, carboplatin and etoposide were administered, resulting in the reduction of the pineal tumor, but no effect was observed in the neurohypophyseal tumor. Histopathological analysis confirmed the pineal lesion as a germinoma, whereas the neurohypophyseal lesion was an embryonal carcinoma. Thus, the treatment was altered to ifosfamide, carboplatin, and etoposide (ICE), leading to a response in both tumors. The patient underwent three additional cycles of ICE therapy and high-dose chemotherapy, followed by whole craniospinal irradiation, achieving complete remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Although most bifocal germ cell tumors share the same histological tissue, occasional differences may arise, necessitating separate biopsies for accurate assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23718","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:22:47Z","timestamp":1709554967000},"source":"Crossref","is-referenced-by-count":1,"title":["Bifocal germ cell tumor of pineal germinoma and neurohypophyseal embryonal carcinoma: illustrative case"],"prefix":"10.3171","volume":"7","author":[{"given":"Yu","family":"Naruse","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Jinguji","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Hiruta","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Toda","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Nagai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Kudo","sequence":"additional","affiliation":[{"name":"Pediatric Oncology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Sano","sequence":"additional","affiliation":[{"name":"Pediatric Oncology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rei","family":"Sekine","sequence":"additional","affiliation":[{"name":"Diagnostic Pathology, Fukushima Medical University, Fukushima, Fukushima, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mudathir","family":"Bakhit","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masazumi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Br J Neurosurg.","first-page":"391","article-title":"So-called intracranial germ cell tumours: are they really of germ cell origin?","volume":"9","author":"Sano K","year":"1995","unstructured":"Sano K So-called intracranial germ cell tumours: are they really of germ cell origin? 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