J Neurol Surg A Cent Eur Neurosurg 2025; 86(02): 213-216
DOI: 10.1055/a-2389-5353
Technical Note

Intraoperative Germinoma Staining: A Technical Note

Emanuil Naydenov
1   Department of Neurosurgery, University Hospital “St. Ivan Rilski,” Sofia, Bulgaria
,
1   Department of Neurosurgery, University Hospital “St. Ivan Rilski,” Sofia, Bulgaria
,
Velislav Pavlov
1   Department of Neurosurgery, University Hospital “St. Ivan Rilski,” Sofia, Bulgaria
,
Dimitar Metodiev
2   Department of Neuropathology, University Hospital “St. Ivan Rilski,” Sofia, Bulgaria
,
Krasimir Minkin
1   Department of Neurosurgery, University Hospital “St. Ivan Rilski,” Sofia, Bulgaria
› Author Affiliations
Funding This research project was supported by Stay Foundation, Sofia, Bulgaria.

Abstract

As the main treatment modality of central neural system germinomas is radiotherapy and/or chemotherapy, the exact initial diagnosis of the disease is crucial. Depending on the different national protocols, histologic verification can be obligatory in some instances. This is a serious challenge, taking into account the usual location and nonspecific macroscopic appearance of these lesions. Here, we propose a safe and effective method of intraoperative tumor enhancement that can increase the confidence of the surgeon during the intervention.

Ethical Approval

This study protocol was reviewed and approved by the Ethical Committee of University Hospital St. Ivan Rilski.


Authors' Contribution

All the authors had substantial contributions to the conception or design of the work; the acquisition, analysis, or interpretation of data for the work; participated in drafting the work or reviewing it critically for important intellectual content; approved the final version of the manuscript; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


The authors confirm their contribution to the final version of the article as follows: study conception and design: E.N.; data collection: E.N. and P.K.; interpretation of results: E.N., D.M., and K.M.; draft manuscript preparation: E.N. and V.P. All the authors reviewed the results and approved the final version of the manuscript.


Patient Consent

Informed written consent was obtained from the participant in the study.




Publication History

Received: 18 February 2024

Accepted: 14 August 2024

Accepted Manuscript online:
16 August 2024

Article published online:
16 October 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 van Leeuwen MT, Gurney H, Turner JJ. et al. Patterns and trends in the incidence of paediatric and adult germ cell tumours in Australia, 1982-2011. Cancer Epidemiol 2016; 43: 15-21
  • 2 Cuccia V, Alderete D. Suprasellar/pineal bifocal germ cell tumors. Childs Nerv Syst 2010; 26 (08) 1043-1049
  • 3 Kremenevski N, Buchfelder M, Hore N. Intracranial germinomas: diagnosis, pathogenesis, clinical presentation, and management. Curr Oncol Rep 2023; 25 (07) 765-775
  • 4 Yeo KK, Nagabushan S, Dhall G, Abdelbaki MS. Primary central nervous system germ cell tumors in children and young adults: a review of controversies in diagnostic and treatment approach. Neoplasia 2023; 36: 100860
  • 5 Shabo E, Czech T, Nicholson JC. et al. Evaluation of the perioperative and postoperative course of surgery for pineal germinoma in the SIOP CNS GCT 96 trial. Cancers (Basel) 2022; 14 (14) 3555
  • 6 de Divitiis O, Angileri FF, d'Avella D, Tschabitscher M, Tomasello F. Microsurgical anatomic features of the lamina terminalis. Neurosurgery 2002; 50 (03) 563-569 , discussion 569–570
  • 7 Gerard IJ, Kersten-Oertel M, Petrecca K, Sirhan D, Hall JA, Collins DL. Brain shift in neuronavigation of brain tumors: a review. Med Image Anal 2017; 35: 403-420
  • 8 Moore GE, Peyton WT, French LA, Walker WW. The clinical use of fluorescein in neurosurgery; the localization of brain tumors. J Neurosurg 1948; 5 (04) 392-398
  • 9 Shinoda J, Yano H, Yoshimura S. et al. Fluorescence-guided resection of glioblastoma multiforme by using high-dose fluorescein sodium. Technical note. J Neurosurg 2003; 99 (03) 597-603
  • 10 Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ. ALA-Glioma Study Group. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 2006; 7 (05) 392-401
  • 11 Takeda J, Nonaka M, Li Y. et al. 5-ALA fluorescence-guided endoscopic surgery for mixed germ cell tumors. J Neurooncol 2017; 134 (01) 119-124
  • 12 Ji SY, Kim JW, Park CK. Experience profiling of fluorescence-guided surgery II: non-glioma pathologies. Brain Tumor Res Treat 2019; 7 (02) 105-111