A 51-year-old Man with Primary Spinal Cord Germinoma
Bibliographic record
Abstract
Germ cell tumors (GCTs) comprise germinoma, teratoma, yolk sac tumor, embryonal carcinoma, choriocarcinoma, and mixed germ cell tumors.Central nervous system (CNS) GCTs account for 2-3% of all primary intracranial neoplasms.CNS GCTs are most prevalent in East Asian populations, with the highest percentage (15%) of GCTs among CNS neoplasms reported in Japanese pediatric patients.1 The most common subtype of CNS GCT is germinoma, which makes up 55-65% of all CNS GCTs. 2 CNS GCTs have subtype-specific treatment protocols and prognoses.Germinomas, in particular, have a reported long-term survival rate greater than 90% with craniospinal irradiation alone.3 CNS germinomas are usually located intracranially, in suprasellar, basal ganglia, and thalamic structures.4 Primary spinal cord germinomas are very rare.Only 45 primary spinal cord germinomas have been reported, two-thirds (30/45) of which occurred in East Asian patients.5,6 Eight of these 45 tumors were located in the cervical spinal cord, and only two were multifocal.5,6 The average age at diagnosis was 25.5 (±9.4) years and the oldest previously reported patient at diagnosis was 39 years old.7 We report a 51-year-old East Asian man with primary spinal cord germinoma, the oldest reported patient with this diagnosis.He presented with a 4-week history of left lower limb and abdomen paresthesia and right lower limb weakness.His history was unremarkable apart from tuberculosis 20 years previously.Physical examination revealed a partial Brown-Sequard pattern of neurological deficit.Increased tone, decreased strength, and an extensor plantar response were present in the right lower limb.Decreased pinprick sensation to the T4 level was observed on the left.Posterior column function (vibration and position sense) was
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".