Clinical Presentation and Tumor Markers
Presenting symptoms were reported for 33 patients (80.5%). Duration of symptoms was available for 18 patients (43.9%) and ranged from one week to 2.5 years (mean 6.9 months). Six of these patients (20%) had symptoms for greater than 6 months. Of the 33 patients whose presenting symptoms were reported, hemiparesis (24.4%) was the most common symptom, followed by visual disturbance (19.5%), nausea/vomiting (17%), lethargy (14.6%), headache (14.6%), polyuria (12.2%), ataxia (9.8%), motor impairment (9.8%), polydipsia (9.8%), head enlargement (7.3%), seizures (2.4%), amenorrhea (2.4%) and facial nerve palsy (2.4%); one tumor was identified on prenatal ultrasound.
Serum AFP and bHCG was tested in 25 and 28 patients, respectively. Of these patients, 14 (58.3%) had elevated serum AFP and 11 (39.3%) had elevated serum bHCG. Cerebrospinal fluid AFP and bHCG was tested in 14 and 12 patients, respectively. Of these patients, six (42.9%) had elevated CSF AFP and four (33.3%) had elevated CSF bHCG. In those with both serum and CSF testing, serum AFP matched CSF AFP in 11 of 12 patients (91.7%) while serum bHCG matched CSF bHCG in 9 of 10 patients (90%). Overall, 17 of 31 patients (54.8%) had elevated AFP, while 12 of 35 patients (34.3%) had elevated bHCG at initial diagnosis.