Central Nervous System Teratoma — Comprehensive Disease Characteristics Report

Target disease

• Disease name: Central nervous system (CNS) teratoma (intracranial and intraspinal)
• Category: CNS germ cell tumor; typically classified within non‑germinomatous germ cell tumors (NGGCT), though “teratoma” itself is a distinct histologic entity. (zygourakis2015managementofcentral pages 1-2)
• MONDO ID / OMIM / Orphanet / MeSH / ICD-10/ICD-11: Not retrievable with the available tools and evidence in this run; below content is derived from peer‑reviewed literature and clinical trial/guideline sources rather than ontology registries.

1. Disease information

Overview (current understanding)

A CNS teratoma is a rare tumor arising in the brain or spinal axis composed of tissues derived from two or more embryonic germ layers (often all three: ectoderm, mesoderm, endoderm). CNS teratomas are generally categorized into mature teratoma, immature teratoma, and malignant teratoma/teratoma with malignant (somatic-like) transformation, and are part of the broader spectrum of CNS germ cell tumors (GCTs). (zygourakis2015managementofcentral pages 1-2, challa2010teratomasincentral pages 1-2, nowacka2025matureteratomaof pages 5-7)

Synonyms and alternative names

• Intracranial teratoma; pineal teratoma; suprasellar teratoma; intraventricular teratoma
• Spinal teratoma; intradural teratoma; intramedullary teratoma; mature cystic teratoma of the spine
• “Growing teratoma syndrome” when a mature teratoma component enlarges during/after chemotherapy with normalized tumor markers (see Treatment). (michaiel2020intracranialgrowingteratoma pages 1-2, satake2024successfulmultimodaltreatment pages 1-3)

Evidence provenance

The evidence used here is primarily aggregated disease-level resources (guidelines, multi-institution cohorts, case series) and some case reports for rare molecular findings and spinal disease presentations. (nakamura2022thejapansociety pages 7-8, takami2023impactoftumor pages 1-2, giron2024primarycentralnervous pages 1-2, zavalaromero2024matureteratomaat pages 1-2)

2. Etiology

Disease causal factors (developmental/mechanistic)

Embryologic origin hypothesis: CNS GCTs (including teratoma) are widely considered to arise from mismigrated primordial germ cells (PGCs) that become sequestered in midline CNS structures, later undergoing malignant transformation; germinomas and PGCs share global DNA hypomethylation patterns supporting this model. (yeo2023primarycentralnervous pages 1-2, tengattini2024primarycooccurrenceof pages 1-2)

Spinal teratoma hypotheses: spinal teratomas are described with two main theories: (1) dysembryogenic theory (disordered local development with pluripotent cells differentiating chaotically) and (2) misplaced germ cell theory (mis-migration of primordial germ cells from yolk sac to gonad), with some authors considering the misplaced germ cell theory more plausible for adult intraspinal teratomas. (ferdause2023spinalintraduralextramedullary pages 3-3)

Risk factors

Robust environmental risk factors are not established in the extracted evidence. Reported syndromic/germline associations and predispositions include: - Down syndrome, Klinefelter syndrome, and JMJD1C variants reported in CNS GCT literature. (yeo2023primarycentralnervous pages 2-3) - Rare clinical observation of testicular dysgenesis syndrome and Down syndrome among cases with co‑occurring gonadal and CNS GCTs. (tengattini2024primarycooccurrenceof pages 1-2) - A PTEN germline variant has been reported as a pediatric cancer predisposition in the context of intracranial GCT biology (evidence in a recent iGTS case report discussion). (satake2024successfulmultimodaltreatment pages 5-7)

Protective factors / Gene–environment interactions

No protective factors or gene–environment interactions specific to CNS teratoma were identified in the retrieved evidence.

3. Phenotypes

CNS teratoma phenotypes are largely driven by tumor location, mass effect, hydrocephalus, and endocrine involvement (suprasellar/hypothalamic–pituitary region). Population-level frequencies are most available for CNS GCT cohorts rather than teratoma-only cohorts.

Table: This table summarizes common presenting symptoms, neurological signs, and endocrine manifestations relevant to CNS teratoma within the broader CNS germ cell tumor literature. It maps each feature to a suggested HPO term and gives frequencies and anatomical context from recent pediatric series and reviews.

Additional phenotype/location patterns: - Pineal region lesions commonly present with obstructive hydrocephalus and dorsal midbrain signs (Parinaud syndrome). (tomita2023pediatricpinealregion pages 1-2, nowacka2025matureteratomaof pages 5-7) - Suprasellar lesions commonly present with hypothalamic–pituitary dysfunction including diabetes insipidus. (giron2024primarycentralnervous pages 1-2, yeo2023primarycentralnervous pages 2-3) - Basal ganglia/thalamic lesions may present with hemiparesis, cranial neuropathy, and protracted neurocognitive decline. (yeo2023primarycentralnervous pages 2-3)

Quality-of-life impacts: neurologic and endocrine sequelae (e.g., motor/sensory deficits, sphincter dysfunction in spinal disease) can persist and affect long-term function, motivating long-term follow-up. (zavalaromero2024matureteratomaat pages 8-9)

4. Genetic / molecular information

Key molecular themes (CNS GCTs with relevance to teratoma)

• Chromosome 12p gain occurs in ~30% of CNS GCT overall and ~50% of NGGCT; it is associated with shorter progression-free and overall survival and appears shared across histologic components, implying an early event. (yeo2023primarycentralnervous pages 1-2)
• MAPK pathway and PI3K/AKT/mTOR pathway alterations (including KIT/RAS and PI3K/AKT1 changes) are common in CNS germinomas; NGGCTs show distinct programs (neuronal differentiation/EMT) and may show Wnt/β‑catenin–associated gene activity. (yeo2023primarycentralnervous pages 1-2, yeo2023primarycentralnervous pages 5-6)
• KIT is commonly overexpressed in pure germinomas and is largely absent in NGGCTs without germinomatous components, supporting biology-driven stratification and targeted-therapy interest (mostly germinoma-focused). (yeo2023primarycentralnervous pages 5-6)

Teratoma-relevant biomarker behavior

In a large international, histology-verified cohort, AFP was often elevated even without yolk sac tumor, especially in immature teratoma; and HCG elevation was restricted to tumors with germinoma or choriocarcinoma components (with a discernible cut‑off separating those). (takami2023impactoftumor pages 1-2)

Notable recent molecular case evidence (2024)

A recent intracranial growing teratoma syndrome case with malignant features reported: - DNA methylation classifier confirming teratoma (high calibrated score) - Copy-number alterations including DMRT1 loss and 12p gain; authors discuss DMRT1’s role in primordial germ cells and teratomagenesis evidence from mouse models. (satake2024successfulmultimodaltreatment pages 3-5, satake2024successfulmultimodaltreatment pages 5-7)

Liquid biopsy and emerging biomarkers (state of the field)

Recent reviews highlight developing noninvasive diagnostics for intracranial GCTs using CSF ctDNA, microRNA clusters (miR‑371‑373, miR‑302/367), and methylation profiling, but CNS-specific validation and clinical integration remain ongoing. (yeo2023primarycentralnervous pages 2-3, yeo2025intracranialgermcell pages 3-4)

5. Environmental information

No specific environmental, lifestyle, toxicologic, or infectious causal factors were identified in the retrieved CNS teratoma-focused evidence.

6. Mechanism / pathophysiology

Causal chain (high-level)

1. Developmental cell-of-origin event: sequestration/mis-migration of pluripotent germ cell–like precursors in CNS midline structures. (yeo2023primarycentralnervous pages 1-2, tengattini2024primarycooccurrenceof pages 1-2)
2. Oncogenic transformation: acquisition of chromosomal and pathway alterations (e.g., 12p gain; MAPK/PI3K pathway changes) promoting survival/proliferation and resisting apoptosis. (yeo2023primarycentralnervous pages 1-2, tengattini2024primarycooccurrenceof pages 8-10)
3. Differentiation into multiple tissue types: teratoma tissue composition leads to heterogeneous imaging features (fat, calcification, cysts) and variable marker secretion. (nowacka2025matureteratomaof pages 5-7, takami2023impactoftumor pages 1-2)
4. Clinical manifestations: local compression (hydrocephalus, brainstem dysfunction, visual/endocrine deficits) and/or dissemination (CSF cytology positivity in some patients). (tomita2023pediatricpinealregion pages 1-2, yeo2023primarycentralnervous pages 3-4, giron2024primarycentralnervous pages 1-2)

Growing teratoma syndrome (treatment-related biological phenomenon)

Intracranial growing teratoma syndrome (iGTS) is defined as paradoxical growth of a (mature) teratoma component during/after therapy for malignant CNS GCT despite normalization of markers; it likely reflects selection/enrichment of mature teratomatous elements not responsive to chemotherapy/radiotherapy and requires surgery. (michaiel2020intracranialgrowingteratoma pages 1-2, nakamura2022thejapansociety pages 5-7)

Suggested ontology terms (examples): - GO biological processes: “cell proliferation”, “germ cell development”, “DNA methylation”, “PI3K signaling”, “MAPK cascade” (IDs not retrieved in this run) - Cell Ontology (CL): “primordial germ cell” (CL term name; ID not retrieved in this run)

7. Anatomical structures affected

Primary sites (intracranial)

Midline structures are typical: - Pineal region, suprasellar region, basal ganglia, thalamus; ventricular involvement may cause hydrocephalus. (zygourakis2015managementofcentral pages 1-2, nowacka2025matureteratomaof pages 5-7)

Spinal axis

• Intradural lesions are described, often extramedullary in some series; other reviews emphasize many adult spinal teratomas are intramedullary and often lumbar/conus-predominant. (challa2010teratomasincentral pages 1-2, zavalaromero2024matureteratomaat pages 7-8)

Suggested UBERON examples (names; IDs not retrieved here): pineal gland, hypothalamus, pituitary gland, spinal cord, conus medullaris.

8. Temporal development

• Typical onset: most CNS GCTs present in childhood/adolescence; median age ~16 years is reported for CNS GCT broadly. (yeo2023primarycentralnervous pages 1-2)
• Spinal disease: adult spinal teratomas are uncommon but reported; symptoms may be slowly progressive and compression-related, with long regrowth intervals reported years after resection (3–13 years). (zavalaromero2024matureteratomaat pages 8-9)
• iGTS timing: in a large international series, iGTS occurred early (median 2 months from diagnosis). (michaiel2020intracranialgrowingteratoma pages 1-2)

9. Inheritance and population

Epidemiology (best available quantitative estimates)

• CNS teratomas comprise ~0.5–1% of primary adult intracranial tumors, and are reported as more frequent in children (~7% in one review). (zygourakis2015managementofcentral pages 1-2)
• Reported regional differences: in Japan/Korea/Taiwan, rates were reported as 1.8–5% in adults and up to 15% in children (proportion among intracranial tumors, per review). (zygourakis2015managementofcentral pages 1-2)
• In an LMIC regional pediatric CNS GCT cohort (AHOPCA, 2001–2021; n=48), there was a male predominance 64.6% and median age 10.2 years. (giron2024primarycentralnervous pages 1-2)

Germline inheritance

CNS teratoma is not established as a classic Mendelian inherited disorder in the retrieved evidence. Reported associations (Down, Klinefelter, JMJD1C) are best viewed as predisposition associations within CNS GCT biology rather than a defined inheritance pattern. (yeo2023primarycentralnervous pages 2-3)

10. Diagnostics

Clinical and imaging diagnostics

• MRI brain/spine with contrast is standard for staging, and CSF cytology via lumbar puncture is standard-of-care; positive CSF cytology is considered metastatic even if spine MRI is normal. (yeo2023primarycentralnervous pages 3-4)
• Imaging patterns in intracranial teratoma are heterogeneous and reflect mixed tissue composition; CT can highlight calcification/bone and MRI signal heterogeneity can reflect fat/cystic components. (nowacka2025matureteratomaof pages 5-7)

Tumor markers (serum and CSF)

• Guidelines strongly recommend measuring AFP and HCG in both serum and CSF when CNS GCT is suspected. (nakamura2022thejapansociety pages 4-5)
• Marker sampling site matters: in a large international cohort, HCG was elevated only in CSF in 3/52 cases, and AFP only in serum in 7/49 cases, supporting routine paired sampling. (takami2023impactoftumor pages 1-2)
• Clinical thresholds are variable across groups, but a commonly used NGGCT threshold is β‑HCG >50 mIU/mL and/or AFP >10 ng/mL, also used operationally in recent regional cohorts. (zhang2025cacaguidelinesfor pages 3-5, giron2024primarycentralnervous pages 2-3)

Marker behavior in immature teratoma (important diagnostic nuance)

AFP can be elevated even without yolk sac tumor histology, particularly in immature teratoma, which complicates marker-only inference of histology. (takami2023impactoftumor pages 1-2)

Pathology

Definitive diagnosis remains histopathologic identification of germ-layer derivatives; immunohistochemistry supports component identification and differentiation from mixed GCT. (zygourakis2015managementofcentral pages 1-2, nowacka2025matureteratomaof pages 5-7)

Differential diagnosis (examples)

Depends on location and imaging; spinal intradural lesions can mimic schwannoma/meningioma; intracranial parenchymal masses may be misdiagnosed as glioma when heterogeneous. (jeong2023adultintramedullarymature pages 1-3)

11. Outcome / prognosis

Histology-driven prognosis

• Mature (benign) teratoma has favorable outcomes with reported 5‑year survival 87–100%.
• Malignant teratoma has worse outcomes with reported 5‑year survival 33–71%. (zygourakis2015managementofcentral pages 1-2, zygourakis2015managementofcentral pages 6-7)
• In an international cohort analysis, immature teratoma had unfavorable prognosis independent of marker status, with 56% 5‑year overall survival. (takami2023impactoftumor pages 1-2)

Growing teratoma syndrome outcomes

In the largest extracted multi-institution iGTS series (n=39): - iGTS frequency 5% among 777 CNS GCT - Gross total resection 79% - 95% alive at median follow-up 5.3 years (michaiel2020intracranialgrowingteratoma pages 1-2)

Resource setting impacts (2024 AHOPCA)

In the AHOPCA cohort (n=48), 5‑year OS 65% overall (germinoma 68%, NGGCT 50.6%), substantially lower than high-income country benchmarks, likely reflecting heterogeneous protocols and incomplete staging resources. (giron2024primarycentralnervous pages 1-2)

Spinal mature teratoma prognosis

Adult spinal teratomas are rare; mature spinal teratomas are reported to have favorable long-term outcomes in reviews (e.g., 10-year survival 92%) with recurrence/regrowth reported (e.g., ~9–11% and regrowth intervals 3–13 years). (zavalaromero2024matureteratomaat pages 8-9)

12. Treatment

Treatment is driven by (i) mature vs immature/malignant features, (ii) secretory vs nonsecretory markers, and (iii) localized vs disseminated disease.

Table: This table summarizes major treatment modalities used in CNS teratoma and related CNS germ cell tumor care, linking each intervention to its clinical context, supporting evidence, and a suggested MAXO term. It is useful for structuring treatment annotations in a disease knowledge base.

Real-world implementations and expert guidance (selected)

• Mature teratoma: surgical resection is primary treatment (strong recommendation in Japanese guideline). (nakamura2022thejapansociety pages 5-7)
• Germinoma suspected: biopsy rather than aggressive resection. (nakamura2022thejapansociety pages 4-5)
• NGGCT/immature teratoma/mixed disease: multimodality therapy; resection of residual tumor after chemotherapy is strongly recommended (Japanese guideline). (nakamura2022thejapansociety pages 5-7)

Clinical trials relevant to NGGCT/teratoma practice

• COG ACNS0122 (NCT00047320; published on ClinicalTrials.gov, 2004): induction carboplatin/etoposide alternating with etoposide/ifosfamide; second-look surgery for <CR; radiotherapy (including CSI with boost) and escalation to high-dose chemotherapy with autologous stem-cell rescue for poor responders; endpoints included 3‑year EFS/PFS/OS and toxicity. (NCT00047320 chunk 1, NCT00047320 chunk 2)
• SIOP CNS GCT II (NCT01424839; ClinicalTrials.gov, 2011): prespecified regimens for germinoma vs NGGCT including stem-cell supported intensification for high-risk NGGCT; resection of residual tumor after 3 courses when indicated; focal RT 54 Gy for localized NGGCT and CSI with boosts for metastatic disease; primary endpoint 5‑year EFS. (NCT01424839 chunk 1, NCT01424839 chunk 2)

13. Prevention

No primary prevention strategies are established. Secondary prevention largely consists of timely diagnosis and appropriate staging (MRI brain/spine, CSF cytology, serum/CSF markers) to reduce undertreatment/overtreatment. (yeo2023primarycentralnervous pages 3-4, nakamura2022thejapansociety pages 4-5)

14. Other species / natural disease

No comparative animal natural disease evidence was identified in the retrieved materials.

15. Model organisms

Model organism systems were not retrieved in the evidence set for this run. One mechanistic clue referenced in the 2024 iGTS report is that Dmrt1 loss increases teratoma incidence in mouse models, but detailed model descriptions were not extracted here. (satake2024successfulmultimodaltreatment pages 5-7)

Key quantitative findings (quick reference)

Table: This table summarizes selected quantitative findings from major CNS teratoma and CNS germ cell tumor studies relevant to diagnosis, epidemiology, treatment, and outcomes. It is useful for quickly comparing marker data, survival estimates, and clinical series characteristics across recent and foundational publications.

Visual evidence (figures/tables)

• A representative pineal teratoma imaging + intraoperative view and a pathology/location table from a large pediatric pineal region surgical series were retrieved and can be used for knowledge-base curation. (tomita2023pediatricpinealregion media 78dd21ef)

Direct abstract-supported statements (selected)

• Tumor markers guide diagnosis/treatment: Takami et al. (2023) state that tumor markers AFP/HCG have “significant diagnostic implications” and that elevation of either can lead to clinical diagnosis of NGGCT without histopathologic confirmation. (takami2023impactoftumor pages 1-2)
• Regional outcomes gap: Girón et al. (2024) report “Overall survival (OS) is above 90% for germinomas and 70%–80% for NGGCT in high-income countries,” but their cohort’s OS was lower, highlighting implementation disparities. (giron2024primarycentralnervous pages 1-2)

Limitations of this report (data gaps)

• Formal identifiers (MONDO/MeSH/ICD/Orphanet/OMIM) could not be retrieved with the available tools.
• Many quantitative epidemiology and survival estimates are derived from CNS GCT cohorts and reviews rather than teratoma-only population registries.
• HPO/GO/CL/UBERON/MAXO IDs were not programmatically validated in this run; where included, they should be verified against the respective ontology releases.

References

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2. (challa2010teratomasincentral pages 1-2): Sundaram Challa, Meetu Agrawal, MeghaS Uppin, MohanaR Patibandla, Suchanda Bhattacharjee, ManasK Panigrahi, Vijay Saradhi, JyotsnaY Rani, and AK Purohit. Teratomas in central nervous system: a clinico-morphological study with review of literature. Neurology India, 58 6:841-6, Nov 2010. URL: https://doi.org/10.4103/0028-3886.73740, doi:10.4103/0028-3886.73740. This article has 61 citations and is from a peer-reviewed journal.

3. (nowacka2025matureteratomaof pages 5-7): Agnieszka Nowacka, Ewa Ziółkowska, Wojciech Smuczyński, Dominika Bożiłow, and Maciej Śniegocki. Mature teratoma of the cerebellum with formed extracranial component. Journal of Clinical Medicine, 14:1994, Mar 2025. URL: https://doi.org/10.3390/jcm14061994, doi:10.3390/jcm14061994. This article has 0 citations.

4. (michaiel2020intracranialgrowingteratoma pages 1-2): George Michaiel, Douglas Strother, Nicholas Gottardo, Ute Bartels, Hallie Coltin, Juliette Hukin, Beverly Wilson, Shayna Zelcer, Jordan R. Hansford, Timothy Hassall, Mohamed S. AbdelBaki, Kristina A. Cole, Lindsey Hoffman, Natasha P. Smiley, Amy Smith, Anna Vinitsky, Nicholas A. Vitanza, Avery Wright, Kee K. Yeo, Lionel M. L. Chow, Magimairajan I. Vanan, Girish Dhall, Eric Bouffet, and Lucie Lafay-Cousin. Intracranial growing teratoma syndrome (igts): an international case series and review of the literature. Journal of Neuro-Oncology, 147:721-730, Apr 2020. URL: https://doi.org/10.1007/s11060-020-03486-9, doi:10.1007/s11060-020-03486-9. This article has 41 citations and is from a peer-reviewed journal.

5. (satake2024successfulmultimodaltreatment pages 1-3): Daiken Satake, Manabu Natsumeda, Kaishi Satomi, Mari Tada, Taro Sato, Noritaka Okubo, Keita Kawabe, Haruhiko Takahashi, Yoshihiro Tsukamoto, Masayasu Okada, Masakazu Sano, Haruko Iwabuchi, Nao Shibata, Masaru Imamura, Chihaya Imai, Hirokazu Takami, Koichi Ichimura, Ryo Nishikawa, Hajime Umezu, Akiyoshi Kakita, and Makoto Oishi. Successful multimodal treatment of intracranial growing teratoma syndrome with malignant features. Current Oncology, 31:1831-1838, Mar 2024. URL: https://doi.org/10.3390/curroncol31040138, doi:10.3390/curroncol31040138. This article has 4 citations.

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7. (takami2023impactoftumor pages 1-2): Hirokazu Takami, Christopher S. Graffeo, Avital Perry, Caterina Giannini, Yoichi Nakazato, Nobuhito Saito, Masao Matsutani, Ryo Nishikawa, David J. Daniels, and Koichi Ichimura. Impact of tumor markers on diagnosis, treatment and prognosis in cns germ cell tumors: correlations with clinical practice and histopathology. Brain Tumor Pathology, 40:124-132, Mar 2023. URL: https://doi.org/10.1007/s10014-023-00460-x, doi:10.1007/s10014-023-00460-x. This article has 15 citations and is from a peer-reviewed journal.

8. (giron2024primarycentralnervous pages 1-2): Ana Verónica Girón, Jessica Blanco-Lopez, Patricia Calderon, Reyna Jiron, Estuardo Pineda, Margarita Montero, Yamel Lizardo, Ute Bartels, and Diana S. Osorio. Primary central nervous system germ cell tumors in central america and the caribbean region: an ahopca 20-year experience. Frontiers in Oncology, Jul 2024. URL: https://doi.org/10.3389/fonc.2024.1393454, doi:10.3389/fonc.2024.1393454. This article has 3 citations.

9. (zavalaromero2024matureteratomaat pages 1-2): Lilian Zavala-Romero, Eliezer Villanueva-Castro, Rudradeep Datta-Banik, Alexis Genaro Ortiz-Altamirano, María Magdalena Rodriguez-Esquivel, Jesús Cienfuegos-Meza, and Juan Nicasio Arriada-Mendicoa. Mature teratoma at the lumbar spinal cord: a case report and literature review. Cureus, Jan 2024. URL: https://doi.org/10.7759/cureus.52307, doi:10.7759/cureus.52307. This article has 3 citations.

10. (yeo2023primarycentralnervous pages 1-2): Kee Kiat Yeo, Sumanth Nagabushan, Girish Dhall, and Mohamed S. Abdelbaki. Primary central nervous system germ cell tumors in children and young adults: a review of controversies in diagnostic and treatment approach. Neoplasia, 36:100860, Feb 2023. URL: https://doi.org/10.1016/j.neo.2022.100860, doi:10.1016/j.neo.2022.100860. This article has 26 citations and is from a domain leading peer-reviewed journal.

11. (tengattini2024primarycooccurrenceof pages 1-2): Francesco Tengattini, Cesare Francesco Soffiati, Pier Paolo Panciani, Marco Zeppieri, Tamara Ius, Shahan Momjian, Karl Schaller, Marco Maria Fontanella, and Lucio De Maria. Primary co-occurrence of gonadal and extragonadal central nervous system (cns) germ cell tumors (gcts): case report and review of the literature. Neuroglia, 5:50-62, Mar 2024. URL: https://doi.org/10.3390/neuroglia5010004, doi:10.3390/neuroglia5010004. This article has 1 citations.

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13. (yeo2023primarycentralnervous pages 2-3): Kee Kiat Yeo, Sumanth Nagabushan, Girish Dhall, and Mohamed S. Abdelbaki. Primary central nervous system germ cell tumors in children and young adults: a review of controversies in diagnostic and treatment approach. Neoplasia, 36:100860, Feb 2023. URL: https://doi.org/10.1016/j.neo.2022.100860, doi:10.1016/j.neo.2022.100860. This article has 26 citations and is from a domain leading peer-reviewed journal.

14. (satake2024successfulmultimodaltreatment pages 5-7): Daiken Satake, Manabu Natsumeda, Kaishi Satomi, Mari Tada, Taro Sato, Noritaka Okubo, Keita Kawabe, Haruhiko Takahashi, Yoshihiro Tsukamoto, Masayasu Okada, Masakazu Sano, Haruko Iwabuchi, Nao Shibata, Masaru Imamura, Chihaya Imai, Hirokazu Takami, Koichi Ichimura, Ryo Nishikawa, Hajime Umezu, Akiyoshi Kakita, and Makoto Oishi. Successful multimodal treatment of intracranial growing teratoma syndrome with malignant features. Current Oncology, 31:1831-1838, Mar 2024. URL: https://doi.org/10.3390/curroncol31040138, doi:10.3390/curroncol31040138. This article has 4 citations.

15. (giron2024primarycentralnervous pages 2-3): Ana Verónica Girón, Jessica Blanco-Lopez, Patricia Calderon, Reyna Jiron, Estuardo Pineda, Margarita Montero, Yamel Lizardo, Ute Bartels, and Diana S. Osorio. Primary central nervous system germ cell tumors in central america and the caribbean region: an ahopca 20-year experience. Frontiers in Oncology, Jul 2024. URL: https://doi.org/10.3389/fonc.2024.1393454, doi:10.3389/fonc.2024.1393454. This article has 3 citations.

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