{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T03:09:57Z","timestamp":1785726597601,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Intracranial germinoma is a rare malignant neoplasm of the central nervous system (CNS) that occurs in children and young adults. The aim of our study was to assess the initial manifestation of the disease, and to find differences in outcomes dependent on time of diagnosis. Methods: The study group consisted of 35 consecutive patients (adults and children) who were treated for intracranial germinoma with radiotherapy at a tertiary centre, and their data were retrospectively collected. We evaluated time from the first symptoms to diagnosis and divided patients into early and delayed diagnosis groups. Delayed diagnosis has been defined as the time from initial presentation to final diagnosis longer than six months. Results: A total of 17 (48.6%) of the patients had delayed diagnoses. Patient survival data spanned a median of six (interquartile range 3\u201312) years. At the time of the diagnosis, patients presented exclusively neurological symptoms in 16 (45.7%) cases, exclusively endocrinological symptoms in five (14.3%) cases, and mixed symptoms in the remaining cases (n = 14; 40.0%). Patients with neurological symptoms had shorter time (p &lt; 0.001) from first symptoms to the final diagnosis (5.91 months) than in patients without them (19.44 months). The delayed diagnosis group presented significantly smaller tumour size (mean maximal dimension 2.35 cm) compared to early diagnosis group (3.1 cm). The 5-year and 10-year survival rates of our patients were 94.3% and 83.4%, respectively. Patients with a delayed diagnosis (n = 17) had a significantly worse (p = 0.02) 10-year OS (63%) compared to the early diagnosis group (n = 18; OS = 100%). Importantly, in five patients (14.29%), initial manifestation occurred before radiological signs of the disease. Conclusion: Our study stresses the need for timely diagnosis in intracranial germinoma, as a delay has a significant impact on the prognosis. In particular, if the tumour is small or causes exclusively endocrinological symptoms, the diagnosis may be difficult and delayed.<\/jats:p>","DOI":"10.3390\/cancers15102789","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T01:58:06Z","timestamp":1684288686000},"page":"2789","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intracranial Germinoma\u2014Association between Delayed Diagnosis, Altered Clinical Manifestations, and Prognosis"],"prefix":"10.3390","volume":"15","author":[{"given":"Iwona","family":"Jab\u0142o\u0144ska","sequence":"first","affiliation":[{"name":"IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7891-672X","authenticated-orcid":false,"given":"Marcin","family":"Go\u0142awski","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u017cbieta","family":"Nowicka","sequence":"additional","affiliation":[{"name":"IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Drosik-Rutowicz","sequence":"additional","affiliation":[{"name":"Ist Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Trybus","sequence":"additional","affiliation":[{"name":"IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6802-5093","authenticated-orcid":false,"given":"Rafa\u0142","family":"Tarnawski","sequence":"additional","affiliation":[{"name":"IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-0827","authenticated-orcid":false,"given":"Marcin","family":"Miszczyk","sequence":"additional","affiliation":[{"name":"IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s11060-006-9282-2","article-title":"Epidemiological Survey of Central Nervous System Germ Cell Tumors in Canadian Children","volume":"82","author":"Keene","year":"2006","journal-title":"J. Neurooncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1038\/nrc1568","article-title":"Testicular Germ-Cell Tumours in a Broader Perspective","volume":"5","author":"Oosterhuis","year":"2005","journal-title":"Nat. Rev. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s11060-014-1562-7","article-title":"Incidence of Intracranial Germ Cell Tumors by Race in the United States, 1992\u20132010","volume":"120","author":"Poynter","year":"2014","journal-title":"J. Neurooncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e470","DOI":"10.1016\/S1470-2045(15)00244-2","article-title":"Consensus on the Management of Intracranial Germ-Cell Tumours","volume":"16","author":"Murray","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1365-2605.2007.00793.x","article-title":"Why Human Extragonadal Germ Cell Tumours Occur in the Midline of the Body: Old Concepts, New Perspectives","volume":"30","author":"Oosterhuis","year":"2007","journal-title":"Int. J. Androl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1093\/molehr\/gaq052","article-title":"Human Primordial Germ Cells Migrate along Nerve Fibers and Schwann Cells from the Dorsal Hind Gut Mesentery to the Gonadal Ridge","volume":"16","author":"Mollgard","year":"2010","journal-title":"Mol. Hum. Reprod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1159\/000210053","article-title":"Pathology of Intracranial Germ Cell Tumors","volume":"23","author":"Sato","year":"2009","journal-title":"Prog. Neurol. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e26543","DOI":"10.1002\/pbc.26543","article-title":"Visual Complaints in Intracranial Germinomas","volume":"64","author":"Frappaz","year":"2017","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1093\/neuonc\/noab252","article-title":"EANO, SNO and Euracan Consensus Review on the Current Management and Future Development of Intracranial Germ Cell Tumors in Adolescents and Young Adults","volume":"24","author":"Frappaz","year":"2021","journal-title":"Neuro-Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1007\/s00234-001-0752-0","article-title":"MRI of Intracranial Germ-Cell Tumours","volume":"44","author":"Liang","year":"2002","journal-title":"Neuroradiology"},{"key":"ref_11","first-page":"95","article-title":"Germinoma of the optic nerve: Case report","volume":"13","author":"Iizuka","year":"1996","journal-title":"Brain Tumor Pathol."},{"key":"ref_12","first-page":"e27535","article-title":"Radiographic Findings of an Intracranial Germinoma in a 42-Year-Old Male","volume":"14","author":"Ostreni","year":"2022","journal-title":"Cureus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.pedneo.2020.07.017","article-title":"Neurological and Endocrinological Manifestations of 49 Children with Intracranial Pure Germinoma at Initial Diagnosis in Taiwan","volume":"62","author":"Chang","year":"2021","journal-title":"Pediatr. Neonatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1212\/01.wnl.0000261908.36803.ac","article-title":"CNS Germ Cell Tumor (CNSGCT) of Childhood: Presentation and Delayed Diagnosis","volume":"68","author":"Crawford","year":"2007","journal-title":"Neurology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3332\/ecancer.2013.333","article-title":"Highlights from the Third International Central Nervous System Germ Cell Tumour Symposium: Laying the Foundations for Future Consensus","volume":"7","author":"Murray","year":"2013","journal-title":"eCancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1093\/neuonc\/nos155","article-title":"Primary CNS Germ Cell Tumors in Japan and the United States: An Analysis of 4 Tumor Registries","volume":"14","author":"McCarthy","year":"2012","journal-title":"Neuro-Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s11060-019-03173-4","article-title":"Descriptive Epidemiology of Germ Cell Tumors of the Central Nervous System Diagnosed in the United States from 2006 to 2015","volume":"143","author":"Gittleman","year":"2019","journal-title":"J. Neurooncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"983","DOI":"10.4143\/crt.2020.1052","article-title":"Long-Term Outcomes and Sequelae Analysis of Intracranial Germinoma: Need to Reduce the Extended-Field Radiotherapy Volume and Dose to Minimize Late Sequelae","volume":"53","author":"Lee","year":"2021","journal-title":"Cancer Res. Treat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S1470-2045(05)70245-X","article-title":"Radiotherapy of Localised Intracranial Germinoma: Time to Sever Historical Ties?","volume":"6","author":"Rogers","year":"2005","journal-title":"Lancet Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S0360-3016(97)00330-1","article-title":"Intracranial Germinoma: The Case for Lower Dose Radiation Therapy","volume":"39","author":"Hardenbergh","year":"1997","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/pbc.22381","article-title":"Primary Chemotherapy for Intracranial Germ Cell Tumors: Results of the Third International CNS Germ Cell Tumor Study","volume":"54","author":"Cappellano","year":"2010","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1093\/neuonc\/not019","article-title":"SIOP CNS GCT 96: Final Report of Outcome of a Prospective, Multinational Nonrandomized Trial for Children and Adults with Intracranial Germinoma, Comparing Craniospinal Irradiation Alone with Chemotherapy Followed by Focal Primary Site Irradiation for Patients with Localized Disease","volume":"15","author":"Calaminus","year":"2013","journal-title":"Neuro-Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kang, Y.-M., Lee, Y.-Y., Lin, S.-C., Chang, F.-C., Hsu, S.P.C., Lin, C.-F., Liang, M.-L., Chen, H.-H., Wong, T.-T., and Lan, K.-L. (2022). Bifocal Lesions Have a Poorer Treatment Outcome than a Single Lesion in Adult Patients with Intracranial Germinoma. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0264641"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Esfahani, D.R., Alden, T., DiPatri, A., Xi, G., Goldman, S., and Tomita, T. (2020). Pediatric Suprasellar Germ Cell Tumors: A Clinical and Radiographic Review of Solitary vs. Bifocal Tumors and Its Therapeutic Implications. Cancers, 12.","DOI":"10.3390\/cancers12092621"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.pediatrneurol.2012.05.025","article-title":"Patterns of Failure in Patients With Primary Intracranial Germinoma Treated With Neoadjuvant Chemotherapy and Radiotherapy","volume":"47","author":"Paximadis","year":"2012","journal-title":"Pediatr. Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s00432-018-2743-0","article-title":"Treatment Outcomes of Intracranial Germinoma: A Retrospective Analysis of 170 Patients from a Single Institution","volume":"145","author":"Lian","year":"2018","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/S0090-3019(01)00575-4","article-title":"Neurohypophyseal Germinoma Traced from Its Earliest Stage via Magnetic Resonance Imaging: Case Report","volume":"56","author":"Oishi","year":"2001","journal-title":"Surg. Neurol."},{"key":"ref_28","first-page":"20","article-title":"Intracranial Germ Cell Tumours: A 21-Year Review","volume":"86","year":"2017","journal-title":"An. Pediatr\u00eda (Engl. Ed.)"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1007\/s00381-010-1247-2","article-title":"Intracranial Germinoma: Clinical and MRI Findings in 56 Patients","volume":"26","author":"Wang","year":"2010","journal-title":"Childs Nerv. Syst."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1038\/sj.eye.6700715","article-title":"Germinoma with Synchronous Involvement of the Pineal Gland and the Suprasellar Region: A Treatable Cause of Visual Failure in a Young Adult","volume":"18","author":"Hadjikoutis","year":"2004","journal-title":"Eye"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/j.1440-1754.1994.tb00570.x","article-title":"CNS Germinomas: Curable Tumours in Two Adolescents","volume":"30","author":"Hill","year":"1994","journal-title":"J. Paediatr. Child Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1210\/jcem-52-1-9","article-title":"Hormonal and Metabolic Abnormalities Associated with Central Nervous System Germinoma in Children and Adolescents and the Effect of Therapy: Report of 10 Patients","volume":"52","author":"Sklar","year":"1981","journal-title":"J. Clin. Endocr. Metab."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/10\/2789\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:36:34Z","timestamp":1760124994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/10\/2789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,17]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["cancers15102789"],"URL":"https:\/\/doi.org\/10.3390\/cancers15102789","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,17]]}}}