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This study was conducted to illustrate the origin of these PE-related ncRNAs in maternal circulation and their underlying transport methods into target cells. We selected 10 women with severe pre-eclampsia (PE group) and 10 healthy participants who served as controls (NC group). Exosomes were isolated from their sera and their origin was determined by a specific marker, placental alkaline phosphatase (PLAP). We compared the ncrna associated with PE in exosomes and whole serum to observe the exchange of serum exosomes with trophoblast cells. The results showed that PLAP was enriched in the isolated exosomes. Seven PE-associated ncRNAs, including lnc-SNHG5, miR-26a-5p, miR-221-3p, miR-30a-3p, miR-18a, miR-152 and miR-155, were analyzed in placenta-derived exosomes and whole serum from both groups. miR-26a-5p, miR-152 and miR-155 were upregulated in the PE group compared with the NC group. 152 and miR-155 were upregulated. 152 and miR-155 were upregulated, while miR-18a and miR-221-3p were downregulated (P<0.05). ncRNAs were altered in serum and placenta-derived serum exosomes in a consistent trend. Fluorescence microscopy results showed that the nuclei were counterstained in HTR-8 cells exposed to PKH26-labeled exosomes. PE-associated ncRNAs can enter the maternal circulation through secretion and encapsulation into placenta-derived exosomes and participate in the development and progression of PE by targeting trophoblast cells. differential expression of ncRNAs in exosomes has the potential to be used as predictors for targeted therapy, providing new ideas and perspectives for improving maternal and infant outcomes. [ABSTRACT FROM AUTHOR]

Placental alkaline phosphatase (PLAP) in the spinal fluid is helpful for the diagnosis of intracranial germinomas. Bifocal lesions involving the pineal and pituitary regions have also been reported as characteristic findings of intracranial germinomas. We present a rare case of a 15-year-old boy with a pineal parenchymal tumor of intermediate differentiation (PPTID) with bifocal lesions negative for PLAP. Magnetic resonance imaging of the brain revealed bifocal mass lesions in the pineal and suprasellar regions and non-communicating hydrocephalus. We initially suspected a germinoma based on imaging findings, but all tumor markers, including PLAP, in the spinal fluid were negative. Based on these results, germinoma was considered less likely, and an endoscopic third ventriculostomy and endoscopic tumor biopsy were performed for diagnosis. The histopathological diagnosis was PPTID, corresponding to World Health Organization grade 3, in both pineal and suprasellar specimens. A craniotomy for tumor removal was performed, resulting in total resection. PLAP is known to have high sensitivity and extremely high negative predictive value for germinomas. Although bifocal lesions highly suggest germ cell tumors, there are exceptions, as in the present case. This case suggests that PLAP measurements are useful for differentiation, leading to appropriate treatment strategies. [ABSTRACT FROM AUTHOR]

Placenta Accreta Spectrum (PAS) is a life-threatening condition in which placental trophoblastic cells abnormally invade the uterus, often up to the uterine serosa and, in extreme cases, tissues beyond the uterine wall. Currently, there is no clinical assay for the non-invasive detection of PAS, and only ultrasound and MRI can be used for its diagnosis. Considering the subjectivity of visual assessment, the detection of PAS necessitates a high degree of expertise and, in some instances, can lead to its misdiagnosis. In clinical practice, up to 50% of pregnancies with PAS remain undiagnosed until delivery, and it is associated with increased risk of morbidity/mortality. Although many studies have evaluated the potential of fetal biomarkers circulating in maternal blood, very few studies have evaluated the potential of circulating placental extracellular vesicles (EVs) and their miRNA contents for molecular detection of PAS. Thus, to purify placental EVs from maternal blood, we customized our robust ultra-sensitive immuno-purification assay, termed EV-CATCHER, with a monoclonal antibody targeting the membrane Placental Alkaline Phosphatase (PLAP) protein, which is unique to the placenta and present on the surface of placental EVs. Then, as a pilot evaluation, we compared the miRNA expression profiles of placental EVs purified from the maternal plasma of women diagnosed with placenta previa (controls, n = 16); placenta lying low in uterus but not invasive) to those of placental EVs purified from the plasma of women with placenta percreta (cases, n = 16), PAS with the highest level of invasiveness. Our analyses reveal that miRNA profiling of PLAP+ EVs purified from maternal plasma identified 40 differentially expressed miRNAs when comparing these two placental pathologies. Preliminary miRNA pathway enrichment and gene ontology analysis of the top 14 upregulated and top nine downregulated miRNAs in PLAP+ EVs, purified from the plasma of women diagnosed with placenta percreta versus those diagnosed with placenta previa, suggests a potential role in control of cellular invasion and motility that will require further investigation. [ABSTRACT FROM AUTHOR]

Preterm labor, one of the common pathological phenomena during pregnancy, necessitates prompt and accurate detection to safeguard the health of both pregnant women and newborns. This study focused on placental alkaline phosphatase, a pregnancy-specific enzyme, and its potential role in identifying preterm labor. This study aimed to investigate the relationship between placental alkaline phosphatase, placental maturity, the nutritional status of newborns, and its utility in evaluating preterm labor. A total of 85 pregnant women with singleton pregnancy of more than 15 weeks of gestation admitted to our hospital from March 2022 to May 2023 were selected as study subjects. Our study revealed a positive correlation between PLAP levels and both gestational age and placental maturity (P < 0.05). Our findings indicated that with an increase in gestational age and placental maturity, there was a corresponding increase in placental alkaline phosphatase levels. However, there were no differences in placental alkaline phosphatase between pregnant women of Grade III and Grade II in terms of placental maturity (P > 0.05). There was a significant increase in placental alkaline phosphatase levels among pregnant women who gave birth prematurely (P < 0.05). The receiver operating characteristic curve showed that placental alkaline phosphatase had an excellent effect on the evaluation of preterm labor (P < 0.05). However, there were no significant differences in placental alkaline phosphatase between the pregnant women with and without postpartum complications (P > 0.05). Lastly, placental alkaline phosphatase was found to have an inverse relationship with levels of neonatal albumin and transferrin levels (P < 0.05). [ABSTRACT FROM AUTHOR]

Purpose: Pineal region tumors (PRT) represent less than 1% of brain neoplasms. The rare and heterogeneous nature of these tumors is reflected in the variety of treatment modalities employed. Methods: A single-center retrospective review of all pediatric patients with pineal region tumors between November 1996 and June 2021 was performed. Fifty-six cases of pineal tumors were reviewed for age and symptoms upon presentation, diagnostic methods, imaging characteristics, histological classification, treatment modalities, recurrence, and mortality rates. Results: The average age at diagnosis was 11.3 years. The majority of patients were male (82.1%) and Caucasian (73.2%). The most common presenting symptoms were headache (n = 38, 67.9%) and visual problems (n = 34, 60.7%). Hydrocephalus was present in 49 patients (87.5%). Germinoma (n = 20, 35.7%) and non-germinomatous germ cell tumor (NGGCT) (n = 17, 30.4%) were the most common tumors. Chemotherapy was employed for 54 patients (96.4%), radiation for 49 (87.5%), and surgical resection for 14 (25.0%). The average duration of treatment was 5.9 months. Progression-free survival was 74.4% at 5 years and 72.0% at 10 years. Overall survival was 85.7% at 5 years and 77.1% at 10 years. Conclusion: Treatment of pineal region tumors must be targeted to each patient based on presentation, subtype, presence of hydrocephalus, and extent of disease. Upfront surgical resection is usually not indicated. As advances in oncological care proceed, treatment modalities may continue to improve in efficacy. [ABSTRACT FROM AUTHOR]

The clinical utility of measuring cerebrospinal fluid placental alkaline phosphatase (CSF-PLAP) was evaluated in three patients with germinoma. CSF-PLAP was elevated in two patients with suprasellar germinoma who were symptomatic before developing typical radiological findings. The third patient, who had been radiologically diagnosed with a pineal mature teratoma, was suspected of having a germinoma component due to elevated CSF-PLAP; this patient received adjuvant radiochemotherapy. The presence of a germinoma-specific tumor marker may aid in the early diagnosis of suspicious cases at initial clinical presentation and in the accurate subtype classification of intracranial germ cell tumors.

Leptomeningeal carcinomatosis, leptomeningeal meningitis, or, as referred here, leptomeningeal metastasis (LM), is a rare but frequently fatal complication seen in advanced stage of cancer either locally advanced or after a metastasis of a known primary cancer. We present a rare and uncommon case of leptomeningeal metastases from carcinoma of unknown primary. A 32-year-old female was diagnosed with LM; however, no known primary carcinoma was identified after 2 separate biopsies. The first biopsy of the right pre-tracheal lymph node showed poorly differentiated pan-keratin (AE1 and AE3) and placental alkaline phosphatase with the possibility of germ cell origin. Second cytology of cervical lymphadenopathy was remarkable for cytokeratin 7 and 20, placental alkaline phosphatase, and CDX2 suggestive of germ line tumor with both mucinous ovarian and gastrointestinal carcinomas. Unfortunately, the LM progressed rapidly despite multiple cycles of germ cell origin directed systemic and intrathecal chemotherapy, and the patient opted for hospice care without getting a chance to identify the primary source.

The biochemical existing tool of diagnostic methods to lung cancer cases need to be improved. In order to validate an early screening of primary tumor patients, a developed a simple procedure or technique was demanded. The aims of this study were to provide an overview of alkaline Placental Alkaline Phosphatase activity in lung cancer. Using heating inactivation method regarding the measurement of Placental Alkaline Phosphatase activity as an early diagnosis marker in lung cancer cases. Total alkaline phosphatase and Placental alkaline phosphatase activity were measured in patients of Lung cancer patients who were classified according to the site of tumor by histological picture. ALP isoenzymes were identified by heat inactivation, and compared with the most frequently applied method (ELISA). Monitoring of the Total ALP and Placental ALP activity in the studied groups using two different methods were shown a highly performance of heating method by an experimental assessment to confirm the accuracy and validity of the proposed method. The distribution of serum placental ALP isoenzyme activity in patients and control groups which was measured by two different methods were found to be (20.2-43.1) IU/L respectively (measured by heating method) and (394.3-454.5) pg/mL measured by ELISA method) respectively. Placental ALP isoenzyme showed a high significant activity in lung cancer patients than healthy control with p value less than (0.05). That application of the heat inactivation method yields similar indication to the ones obtained by the highly and specific enzyme-linked immunosorbent assay. The results of detection Placental alkaline phosphatase in serum were in excellent agreement and could have a potentially extensive application for Placental alkaline phosphatase quantification. [ABSTRACT FROM AUTHOR]

Objective: To investigate the mutual regulation of hypoxia‐inducible factor (HIF)‐1α activity and periodontal ligament‐associated protein‐1 (PLAP‐1) expression in human periodontal ligament cells (HPDLs). Background: Cellular responses to hypoxia regulate various biological events (e.g., inflammation and tissue regeneration) through activation of HIF‐1α. PLAP‐1, an extracellular matrix protein preferentially expressed in the periodontal ligament, plays important roles in the functions of HPDLs. Although PLAP‐1 expression has been demonstrated in hypoxic regions, the involvement of PLAP‐1 in responses to hypoxia has not been revealed. Methods: HPDLs were cultured under normoxic (20% O2) or hypoxic (1% O2) conditions with or without deferoxamine mesylate (chemical hypoxia inducer) or chetomin (HIF signaling inhibitor). Expression levels of PLAP‐1 and HIF‐1α were examined by real‐time reverse transcription‐polymerase chain reaction and western blot analysis. Luciferase reporter assays of HIF‐1α activity were performed using 293T cells stably transfected with a hypoxia response element (HRE)‐containing luciferase vector in the presence or absence of recombinant PLAP‐1 or PLAP‐1 gene transfection. Results: Cultivation under hypoxic conditions elevated the gene and protein expression levels of PLAP‐1 in HPDLs. Deferoxamine mesylate treatment also enhanced PLAP‐1 expression in HPDLs. Hypoxia‐induced PLAP‐1 expression was significantly suppressed in the presence of chetomin. PLAP‐1‐suppressed HPDLs showed increased HIF‐1α accumulation in the nucleus during culture under hypoxic conditions, but not in the presence of recombinant PLAP‐1. In the presence of recombinant PLAP‐1, hypoxia‐induced HRE activity of 293T cells was significantly suppressed in a dose‐dependent manner. Transfection of the PLAP‐1 gene resulted in a significant reduction of HRE activity during culture under hypoxic conditions. Conclusion: PLAP‐1 expression is upregulated under hypoxic conditions through HIF‐1α activation. Moreover, hypoxia‐induced PLAP‐1 expression regulates HIF‐1α signaling. [ABSTRACT FROM AUTHOR]

Extragonadal germ cell tumors are relatively rare tumor, which usually occurs in the mediastinum or retroperitoneum. In this report, we present a case of primary mixed germ cell tumor (GCT) arising in the pelvic cavity. A 38-year-old male with acute abdominal pain was admitted to our hospital. Computed tomography scan imaging demonstrated a large mass in the pelvic cavity. Histological examination of the specimen revealed germ cell tumor with dual morphology. Immunohistochemical studies detected placental alkaline phosphatase (ALP), OCT3/4, ALP, and pancytokeratin. Taking these results together with the patient's other clinical manifestations, this case was diagnosed with mixed GCT, i.e., seminoma plus yolk sac tumor. Chemotherapy was successful. Mixed germ cell tumor in the pelvic cavity is extremely rare but should be considered as a cause of pelvic mass formation.

Reports on abdominal tumours in koi carp are scarce and most are from the gonads. Their histological diagnosis is challenging due to the occurrence of mixed populations of neoplastic cells and the few availability of cross‐reactive antibodies in fish tissues. The present study aims to provide a histopathological characterization of seventeen gonadal tumours, enriched by a wide antibody panel (vimentin, CD117, placental alkaline phosphatase—PLAP, AE1/AE3 cytokeratin, E‐cadherin, proliferating cell nuclear antigen—PCNA, müllerian‐inhibiting substance—MIS, GATA4 and Inhibin‐α) applied on whole and tissue microarray (TMA) sections. Abdominal enlargement was associated with tumours filling 30%–80% of the abdominal cavity; frequently, the gonads had been completely replaced by neoplastic tissue. Twelve cases were characterized as sex cord‐stromal tumours (SCSTs), three as germ cell tumours (GCTs), one as mixed germ cell sex cord‐stromal tumour (MGCSCST) and one as carcinoma. By immunohistochemistry, PLAP enabled confirmation of GCTs, ovarian carcinoma and the objective identification of a further cell component in 8 out of the 12 SCSTs that were reclassified as mixed tumours. The use of an immunohistochemical panel can help in refining the histological diagnosis, but the morphological diagnosis still represents the main tool for the characterization of these tumours in koi carp. [ABSTRACT FROM AUTHOR]

Objective: Most types of intracranial germ cell tumors (IGCTs) are sensitive to chemoradiation. However, biopsy specimens are usually small and thus cannot be used for obtaining an accurate pathological diagnosis. Recently, the cerebrospinal fluid (CSF) placental alkaline phosphatase (PLAP) value has been considered a new biomarker of IGCTs. The present study aimed to evaluate the discriminatory characteristics of the CSF-PLAP value upon diagnosis and at the time of recurrence in patients with IGCTs. Methods: Between 2015 and 2019, this study included 37 patients with tumors located in the intraventricular and/or periventricular region. The CSF-PLAP level was assessed before the patients received any treatment. The PLAP level was evaluated during and after first-line chemoradiotherapy in 7 patients with IGCTs. The CSF-PLAP values were compared according to histological diagnosis, and the correlation between these values and radiographical features was assessed. The CSF-PLAP values of 6 patients with IGCTs with suspected recurrence were evaluated based on neuroimaging findings. Results: The CSF-PLAP values were significantly higher in patients with IGCTs than in those with other types of brain tumor (n = 19 vs. 18; median: 359.0 vs. <8.0 pg/mL). The specificity and sensitivity were 88 and 95%, respectively, with a cutoff value of 8.0 pg/mL. In patients with IGCT, the CSF-PLAP value was higher in patients with germinoma than in those with nongerminomatous germ cell tumors (n = 12 vs. 7; median: 415.0 vs. 359.0 pg/mL). Regarding the time course, the CSF-PLAP value decreased to below the detection limit after the reception of first-line chemoradiotherapy in all 7 patients. A significant correlation was observed between the initial CSF-PLAP value and the tumor reduction volume after receiving first-line chemoradiotherapy (p < 0.0003, R2 = 0.6165, logY = 1.202logX – 1.727). Among the patients with suspected IGCT recurrence (n = 6), the CSF-PLAP value was high in patients with recurrence (n = 3; median: 259.0 pg/mL), and that in patients (n = 3) without recurrence was below the lower detection limit. Conclusions: The CSF-PLAP level is a useful biomarker during the initial diagnosis of IGCTs and at the time of recurrence. It may be associated with the volume of germinomatous components of tumors. [ABSTRACT FROM AUTHOR]

Extragonadal germ cell tumors are relatively rare tumor, which usually occurs in the mediastinum or retroperitoneum. In this report, we present a case of primary mixed germ cell tumor (GCT) arising in the pelvic cavity. A 38-year-old male with acute abdominal pain was admitted to our hospital. Computed tomography scan imaging demonstrated a large mass in the pelvic cavity. Histological examination of the specimen revealed germ cell tumor with dual morphology. Immunohistochemical studies detected placental alkaline phosphatase (ALP), OCT3/4, ALP, and pancytokeratin. Taking these results together with the patient's other clinical manifestations, this case was diagnosed with mixed GCT, i.e., seminoma plus yolk sac tumor. Chemotherapy was successful. Mixed germ cell tumor in the pelvic cavity is extremely rare but should be considered as a cause of pelvic mass formation. [ABSTRACT FROM AUTHOR]

ABSTRACT Zika virus (ZIKV) infection during pregnancy causes intrauterine growth defects and microcephaly, but knowledge of the mechanism through which ZIKV infects and replicates in the placenta remains elusive. Here, we found that ALPP, an alkaline phosphatase expressed primarily in placental tissue, promoted ZIKV infection in both human placental trophoblasts and astrocytoma cells. ALPP bound to ZIKV structural and nonstructural proteins and thereby prevented their proteasome-mediated degradation and enhanced viral RNA replication and virion biogenesis. In addition, the function of ALPP in ZIKV infection depends on its phosphatase activity. Furthermore, we demonstrated that ALPP was stabilized through interactions with BIP, which is the endoplasmic reticulum (ER)-resident heat shock protein 70 chaperone. The chaperone activity of BIP promoted ZIKV infection and mediated the interaction between ALPP and ZIKV proteins. Collectively, our findings reveal a previously unrecognized mechanism through which ALPP facilitates ZIKV replication by coordinating with the BIP protein. IMPORTANCE ZIKV is a recently emerged mosquito-borne flavivirus that can cause devastating congenital Zika syndrome in pregnant women and Guillain-Barré syndrome in adults, but how ZIKV specifically targets the placenta is not well understood. Here, we identified an alkaline phosphatase (ALPP) that is expressed primarily in placental tissue and promotes ZIKV infection by colocalizing with ZIKV proteins and preventing their proteasome-mediated degradation. The phosphatase activity of ALPP could be required for optimal ZIKV infection, and ALPP is stabilized by BIP via its chaperone activity. This report provides novel insights into host factors required for ZIKV infection, which potentially has implications for ZIKV infection of the placenta.

Pineal region germ cell tumors are a heterogenous group of tumors; of these, pure germinoma shows high sensitivity to adjuvant therapy, and the timing and sequence of surgical intervention and adjuvant/neoadjuvant therapy are important for devising a treatment strategy for intracranial germ cell tumors (IGCT). Biopsy is diagnostically useful, but is often insufficient because only a limited amount of specimen can be obtained. In the present study, we aimed to determine the value of cerebrospinal fluid placental alkaline phosphatase (PLAP) levels, reflecting the presence of germinoma, as a reliable indicator to determine treatment strategies for pineal germ cell tumors. To assess the relationship between elevated PLAP levels and the presence of germinoma, we retrospectively reviewed histopathological findings of 25 surgical cases of IGCT in the pineal region. The PLAP value reflects the existence of a germinoma component within a total tumor volume; consequently, tumor volume could be reduced in cases with elevated PLAP, while tumors negative for PLAP did not decrease in size. Therefore, PLAP levels may help neurosurgeons optimize surgical intervention timing for teratomas in the pineal region. [ABSTRACT FROM AUTHOR]

The Queensland fruit fly, Bactrocera tryoni, is considered one of the worst horticultural pests in Australia attacking a large variety of fruit crops. To defeat pest insects, olfactory attractants have been developed and widely used in lure and kill strategies. Male B. tryoni are strongly attracted to the compound raspberry ketone and its synthetic analog, cuelure. Despite the strong behavioral response, a recent study failed to show any activation of antennal receptors to cuelure. Therefore, we hypothesized that cuelure may be detected by an accessory olfactory organ, the maxillary palp. Combining behavioral and physiological experiments we clearly demonstrate that male flies, but not female flies, primarily use the maxillary palps and not the antennae to detect and respond to cuelure. Furthermore, regardless of satiety status, male flies always preferred cuelure over a sugar rich source, unless the maxillary palps were excised. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most common malignancies diagnosed in pregnancy. Although the tumor is often detected at an advanced stage, placental metastases are rare. Here, we describe the case of a woman with breast cancer recurrence during pregnancy and subsequent metastases. The focus of this study is the large amount of placenta metastases, which have been analyzed immunohistochemically. Staining with trophoblast markers (placenta alkaline phosphatase, beta human chorionic gonadotropin and human placental lactogen) showed the strict localization of metastases in the intervillous space without invasion into fetal tissue. They have a large spheroidal shape and are free of blood vessels. Staining with Ki‐67 revealed an outer proliferative shell and inner necrotic core. At week 28, a healthy newborn was born by elective cesarean section. A few weeks later, after surgery and FEC60 (fluorouracil, epirubicin, cyclophosphamide) cycles, the patient died. Breast cancer metastases in the placenta are rarely described. The special immunological environment in pregnancy may influence phenotype, growth, and behavior of tumor and metastases. [ABSTRACT FROM AUTHOR]

Wandogarida canalicula gen. n et sp. n. (Tanaidacea, Sphyrapodidae) is described from the southern coast of Korea (NW Pacific). The genus is included in the subfamily Sphyrapodinae Guţu, 1980 by having a mandible lacking a palp. It has a close affinity with the genus Poligarida Bamber & Marshall, 2013 in the third pereonite having lateral pointed apophyses, the antennule of males with fringes of aesthetascs on articles 1 and 2 of the outer flagellum and the antenna with an elongate article 2. However, it is distinguished from Poligarida by having a maxillular palp. Wandogarida gen. n. can be differentiated from other genera within the subfamily Sphyrapodinae by the unique shape characterised by the male's antennule article 1 with its rough denticles and a deep groove, pleonites each with a ventral hyposphenium, the maxillule with uniarticulate palp and the presence of prominent sexual dimorphism in the mouthparts. An identification key to the five genera of the subfamily Sphyrapodinae is presented. [ABSTRACT FROM AUTHOR]

Summary Testicular seminoma is reported in the rabbit but data about the immunophenotype of these tumours are lacking. The classification of human testicular germ cell tumours includes spermatocytic tumour (ST) originating from the post-pubertal spermatogonia/spermatocytes, which metastasizes rarely, and seminoma (SE), originating from gonocytes, which is malignant and metastasizes frequently. Gonocytes express placental alkaline phosphatase (PLAP) and are stained with periodic acid–Schiff (PAS). We report five cases of seminoma in pet rabbits. Microscopically, all the cases were diffuse seminoma and in one case there was metastasis to a sublumbar lymph node. Immunohistochemical expression of PLAP was diffuse in this metastatic tumour, in two other cases it was multifocal, in another it was limited to rare cells and in the remaining case was negative. PAS-positive cells were detected only in the four cases that expressed PLAP. These four cases were therefore classified as SE and the tumour without PLAP labelling or PAS staining was defined as ST. Both forms of human germ cell tumour therefore occur in the rabbit. SE appears to be well represented and may show metastasis, paralleling the human counterpart. The results of this study provide a basis for further evaluations of the rabbit as a possible animal model for the study of human SE. [ABSTRACT FROM AUTHOR]

Aim: We aimed to research whether fetal gender affects maternal placental alkaline phosphatase (ALP) levels in uncomplicated pregnancies with late term. Materials and Methods: The serum placental ALP measurement was carried out in 88 healthy pregnant women at 38 - 39 weeks of gestation. Infant sex was determined at the delivery for all women included in this study. Placental ALP levels were compared between pregnant women bearing female and male fetuses. Results: Although placental ALP levels were slightly higher in pregnant women carrying female fetuses than in male bearing pregnant women, this difference was not statistically significant (p > 0.05). Conclusions: Fetal gender was seen not to affect maternal serum placental ALP levels in healthy pregnant women at 38 - 39 weeks of gestation. [ABSTRACT FROM AUTHOR]

We present a pediatric case of neurohypophyseal germinoma with a perifocal inflammatory reaction (PIR) with volume fluctuation caused by diagnostic radiation-induced regression (DRIR). On-target biopsy failed to confirm the histology because PIR hardly contained any germinoma cells. DRIR-related fluctuation of the tumor volume disguised germinoma as inflammation. We analyzed the cerebrospinal fluid (CSF) and detected a high level of placental alkaline phosphatase (PLAP), which demonstrated the neurohypophyseal lesion to be germinoma and brought the patient from successful radiochemotherapy up to complete remission. PIR adjacent to the germinoma (PIRAG) disappeared completely following radiochemotherapy, although it contained almost no germinoma cells. Examination of the CSF-PLAP level can complement the diagnosis of germinoma and will decrease the risk of misdiagnosis. Neurosurgeons should keep in mind PIRAG, DRIR, and the diagnostic value of CSF-PLAP when germinoma is suspected. [ABSTRACT FROM AUTHOR]