Endocrine Abstracts

JOINT3308

Objective: A retrospective study was performed in children with beta-hCG-producing germ cell tumors (GCTs) under 18 years of age to evalute the levels of serum as well as cerabral spinal fluid(CSF) hCG.

Methods: From 2000 to 2023, 988 GCTs under 18 yeas of age were diagnosed in our hospital, in whom 60 children were beta-hCG-producing GCTs and were enrolled in our study. Serum hCG levels and hCG levels in cerabral spinal fluid(CSF) hCG were collected and comparaed between intracrinial and extracranial pateints.

Results: In 60 children, 53 males (88. 3%) and 7 females (11. 7%). The median age at presentation was 8. 7 years (range: 3. 2–14. 8 years). 49 were intracranial GCTs, while 11 were extracranial. All of the children with intracranial GCTs had increased levels of hCG in CSF, and CSF hCG levels had positive correlationship with serum hCG levels (R=0. 81, P<0. 01), however, 14 cases (32. 6%) exhibited CSF hCG levels lower than serum hCG levels at the same time. In children with extracranial GCTs, no one had increased hCG levels in CSF (<3 mIU/mL). No statistically significant differences of serum hCG levels were found between genders (P=0. 90) or between intracranial and extracranial groups (P=0. 90). Both serum and CSF hCG levels be found fluctuated during the course before treatment, occasionally dropping below the normal range (3 mIU/mL). 21 patients complished pathological diagnosis, in whom 10 were germinoma, 11 were non germinoma GCTs(NGGCTs). In 10 pathological diagnosed germinoma, 5 had serun and/or CSF hCG excreed 50mIU/mL, while in 11 NGGCTs only 6 had hCG levels more than 50mIU/mL.

Conclusion: hCG-secreting GCTs are more prevalent in males in children. Serum and CSF hCG level are valuable for diagnosis and localization of the tumors. Elevated CSF hCG levels reveal intracranial GCTs, however, CSF hCG levels lower than serum hCG can not rule out CNS lesions. Serum/CSF hCG levels are not always consistent with pathological diagnosis of HCG secreting GCTs in children. Nevertheless, due to the fluctuations of hCG levels during the course, multiple sampling at different time points may be necessary, espacially when the test of hCG was negtive.

Key words: endocrine complications, germ cell tumors, tumor markers/human chorionic gonadotropin, children, adolescents