{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:04:50Z","timestamp":1781528690638,"version":"3.54.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"8","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,2,24]]},"abstract":"\n BACKGROUND<\/jats:title>\n Diagnosing intracranial mixed germ cell tumors (GCTs) can be challenging due to intratumoral heterogeneity. Placental alkaline phosphatase (PLAP) in the cerebrospinal fluid (CSF) is a highly sensitive and specific marker for identifying pure germinomas and germinoma components within mixed GCTs.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors present the case of a 6-year-old boy presenting with a 5-day history of vomiting and headache. Magnetic resonance imaging revealed a heterogeneously enhanced mass with cystic areas in the pineal region. Preoperative serum levels of alpha-fetoprotein and human chorionic gonadotropin, as well as CSF PLAP levels, were not elevated, leading to a preliminary diagnosis of mature teratoma. The tumor was completely resected, and pathological examination of the resected tissue confirmed a mature teratoma with germinoma components. Given the diagnosis of mixed GCT with a germinoma component, the patient underwent postoperative radiation chemotherapy. There has been no recurrence after 8 years of follow-up.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n In this case, the preoperative CSF PLAP level failed to predict the presence of a germinoma component. This report highlights a potential limitation of CSF PLAP as a diagnostic marker, noting that CSF PLAP may be undetectable if the germinoma is confined to a localized area.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24588<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24588","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T02:57:16Z","timestamp":1740365836000},"source":"Crossref","is-referenced-by-count":3,"title":["Mature teratoma with a germinoma component presenting with undetectable placental alkaline phosphatase in cerebrospinal fluid: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7972-0219","authenticated-orcid":true,"given":"Sogo","family":"Oki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-5888","authenticated-orcid":true,"given":"Shigeru","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michinari","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4834-2619","authenticated-orcid":true,"given":"Yukitomo","family":"Ishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Kanno-Okada","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Takakuwa","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1700-5337","authenticated-orcid":true,"given":"Yukayo","family":"Terashita","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsuke","family":"Hirabayashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8272-7603","authenticated-orcid":true,"given":"Kentaro","family":"Nishioka","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hokkaido University Graduate School of Biomedical Science and Engineering, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5276-3665","authenticated-orcid":true,"given":"Takayuki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hokkaido University Graduate School of Biomedical Science and Engineering, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Manabe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0991-0516","authenticated-orcid":true,"given":"Miki","family":"Fujimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"J Neurosurg Pediatr","first-page":"517","article-title":"Long-term consequences of residual lesions after chemoradiotherapy in patients with germinoma at onset","volume":"30","author":"Yamaguchi","year":"2022","unstructured":"Yamaguchi SOkamoto MIshi YLong-term consequences of residual lesions after chemoradiotherapy in patients with germinoma at onset. 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Neuro Oncol. 2021;23(8):1231-1251."},{"issue":"3","key":"bib20","series-title":"Neurosurgery","first-page":"563","article-title":"Novel diagnostic methods and posttreatment clinical phenotypes among intracranial germ cell tumors","volume":"87","author":"Takami","year":"2020","unstructured":"Takami HPerry AGraffeo CSGiannini CDaniels DJ.Novel diagnostic methods and posttreatment clinical phenotypes among intracranial germ cell tumors. Neurosurgery. 2020;87(3):563-572."},{"issue":"3","key":"bib21","series-title":"J Neurosurg","first-page":"446","article-title":"Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases","volume":"86","author":"Matsutani","year":"1997","unstructured":"Matsutani MSano KTakakura KPrimary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg. 1997;86(3):446-455."},{"issue":"1","key":"bib22","series-title":"Eur J Cancer","first-page":"104","article-title":"Germ cell tumours of the central nervous system: treatment consideration based on 111 cases and their long-term clinical outcomes","volume":"34","author":"Sawamura","year":"1998","unstructured":"Sawamura YIkeda JShirato HTada MAbe H.Germ cell tumours of the central nervous system: treatment consideration based on 111 cases and their long-term clinical outcomes. Eur J Cancer. 1998;34(1):104-110."},{"issue":"5","key":"bib1","series-title":"J Neurosurg Pediatr","first-page":"517","article-title":"Long-term consequences of residual lesions after chemoradiotherapy in patients with germinoma at onset","volume":"30","author":"Yamaguchi","year":"2022","unstructured":"Yamaguchi SOkamoto MIshi YLong-term consequences of residual lesions after chemoradiotherapy in patients with germinoma at onset. J Neurosurg Pediatr. 2022;30(5):517-524."},{"issue":"3","key":"bib2","series-title":"Med Res Arch","first-page":"1719","article-title":"Primary central nervous system germ cell tumors: a review and update","volume":"6","author":"Fetcko","year":"2018","unstructured":"Fetcko KDey M.Primary central nervous system germ cell tumors: a review and update. Med Res Arch. 2018;6(3):1719."},{"issue":"9","key":"bib3","series-title":"Lancet Oncol","first-page":"e470","article-title":"Consensus on the management of intracranial germ-cell tumours","volume":"16","author":"Murray","year":"2015","unstructured":"Murray MJBartels UNishikawa RFangusaro JMatsutani MNicholson JC.Consensus on the management of intracranial germ-cell tumours. 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Childs Nerv Syst. 2012;28(7):1017-1024."},{"issue":"1","key":"bib6","series-title":"J Neurooncol","first-page":"23","article-title":"Human chorionic gonadotropin is expressed virtually in all intracranial germ cell tumors","volume":"124","author":"Takami","year":"2015","unstructured":"Takami HFukushima SFukuoka KHuman chorionic gonadotropin is expressed virtually in all intracranial germ cell tumors. J Neurooncol. 2015;124(1):23-32."},{"issue":"5","key":"bib7","series-title":"J Neurosurg Pediatr","first-page":"573","article-title":"Human chorionic gonadotropin detection in cerebrospinal fluid of patients with a germinoma and its prognostic significance: assessment by using a highly sensitive enzyme immunoassay","volume":"18","author":"Fukuoka","year":"2016","unstructured":"Fukuoka KYanagisawa TSuzuki THuman chorionic gonadotropin detection in cerebrospinal fluid of patients with a germinoma and its prognostic significance: assessment by using a highly sensitive enzyme immunoassay. J Neurosurg Pediatr. 2016;18(5):573-577."},{"key":"bib8","series-title":"Eur J Med Res","article-title":"An update on the clinical diagnostic value of \u03b2-hCG and \u03b1FP for intracranial germ cell tumors","volume":"21","author":"Hu","year":"2016","unstructured":"Hu MGuan HLau CCAn update on the clinical diagnostic value of \u03b2-hCG and \u03b1FP for intracranial germ cell tumors. Eur J Med Res. 2016;21:10."},{"key":"bib9","series-title":"J Clin Neurosci","first-page":"23","article-title":"Pineal germ cell tumors: two cases with review of histopathologies and biomarkers","volume":"38","author":"Nagasawa","year":"2017","unstructured":"Nagasawa DTLagman CSun MPineal germ cell tumors: two cases with review of histopathologies and biomarkers. 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J Neurosurg. 2019;131(3):687-694."},{"issue":"2","key":"bib12","series-title":"J Neurooncol","first-page":"405","article-title":"Precise detection of the germinomatous component of intracranial germ cell tumors of the basal ganglia and thalamus using placental alkaline phosphatase in cerebrospinal fluid","volume":"152","author":"Chiba","year":"2021","unstructured":"Chiba KAihara YKawamata T.Precise detection of the germinomatous component of intracranial germ cell tumors of the basal ganglia and thalamus using placental alkaline phosphatase in cerebrospinal fluid. 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