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Introduction
Germ cell tumors (GCTs) are a type of tumor that originates from germ cells, which are the precursors of reproductive cells (sperm and eggs). Unlike somatic cells, which form the body’s tissues and organs, germ cells are responsible for reproduction. In the context of the central nervous system (CNS), GCTs arise when germ cells fail to migrate to the gonads during fetal development and instead remain in the brain or spinal cord. These tumors can be classified into germinomas and non-germinomatous germ cell tumors (NGGCTs), each with distinct pathological and clinical characteristics. Primary germ cell tumors of the central nervous system are rare, accounting for only about 0.4% of primary brain tumors, with a higher incidence in Asian pediatric populations [1, 2, 3–4], and it is rarer for dissemination to cause metastasis of different sites, about 0.98% [3, 5, 6–7]. The main therapy includes surgery resection, radiotherapy, and chemotherapy [3, 7, 8–9]. Because the cancer cells spread to different parts of the central nervous system, increasing the treatment difficulty, resulting in poor prognosis and high mortality.
The most common brain tumors that metastasize outside the nervous system are glioblastoma, medulloblastoma, and germ cell tumors [5, 10]. However, the situation of intracranial germ cell tumors is more complicated. CNS GCTs can be divided into germinomas and non-germinomatous GCTs (NGGCTs) [3, 9, 11]. Although these tumor cells tend to spread directly through the cerebrospinal fluid, it is extremely rare to spread along the ventriculoperitoneal shunt. Because of the rarity and more complex nature of the tumor, insufficient understanding of it and inadequate treatment will lead to a very poor prognosis. Previous and recent studies have highlighted the role of ventriculoperitoneal shunts in facilitating extraneural metastasis of CNS GCTs [12, 13–14].
Unfortunately, many of these studies have been limited to case reports and simple summaries [5, 6, 10, 15, 16, 17, 18–19], rather than a more detailed look at the disease from a unique perspective. Based on prior evidence, we propose that the spread is the perspective from which the analysis can be refined, and the disease can be further examined through new concepts. So, the purpose of this study was to innovatively systemic analyze dissemination by concepts based on clinical practice, and to reveal the characteristics...