ID #1142 Neuropsychological outcomes in pediatric patients with intracranial germ cell tumors: a case series
Maria Luigia Censullo, Marco Di Nicola, Carla Fonte, Milena Guidi, Marco Tellini, Barbara Castelli, Elena Pasquinelli, Bianca Tirinnanzi, Chiara Ester La Torre, Rachele Amato, Laura Calonaci, Laura Giunti, Rosanna Martin, Iacopo SardiAbstract
Introduction
Intracranial germ cell tumors (iGCTs) have a high survival rate due to a multimodal approach, including surgery, chemotherapy and radiotherapy. Neuropsychological assessment in these patients is important for monitoring potential cognitive difficulties. However, data on their cognitive profiles remain limited.
Materials and Methods
Nine patients with iGCT (median age at diagnosis = 14 years; 7 males; 3 with germinomatous and 6 with non-germinomatous germ cell tumors) were evaluated at Meyer Children’s Hospital IRCCS. Lesions were located in the pineal region (n = 4), sellar/suprasellar area (n = 3), and bifocal (n = 2). Two of the three patients with germinoma presented with metastatic disease. All patients were assessed using the Wechsler scales and cognitive batteries. Assessments were conducted at different time points: 3 patients were evaluated both before radiotherapy and at the end of treatment, 4 patients only at FU, and 2 patients at baseline only.
Results
Overall, cognitive-intellectual profiles were within the normal range. Intellectual functioning was average in all patients at both baseline (5/5) and FU (7/7). Visual attention was preserved, with all patients scoring within the average range at baseline and 6/7 at FU and 1/7 scored at the lower limit. Verbal fluency, visuospatial skills, and language abilities were within normal limits at baseline and FU. Verbal memory—both immediate and delayed recall—emerged as the most vulnerable function, with difficulties particularly pronounced in patients with pineal region tumors. All 3 patients assessed post-surgery and before radiotherapy showed immediate recall difficulties, persisting in 5/7 patients at FU. Delayed recall was impaired in 2/5 patients at baseline and in 3/7 patients at FU.
Conclusions
Our findings highlight verbal memory as the most vulnerable cognitive function in iGCTs, reflecting both mnemonic and executive processes. These results support the need for longitudinal neuropsychological monitoring to guide early and individualized rehabilitative interventions, preserving long-term cognitive functioning and quality of life.