Germinoma with Involvement of Midline and Off-Midline Intracranial Structures
Germinomas are malignant intracranial germ tumors, usually found in suprasellar regions. Less than 10% are localized in off-middle structures, and synchronous involvement of both structures has only exceptionally been published. A case of an 18-year-old male patient with progressive right-sided hemi...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2014/936937 |
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| author | Monica Graciela Loto Karina Danilowicz Santiago González Abbati Rafael Torino Alejandro Misiunas |
| author_facet | Monica Graciela Loto Karina Danilowicz Santiago González Abbati Rafael Torino Alejandro Misiunas |
| author_sort | Monica Graciela Loto |
| collection | DOAJ |
| description | Germinomas are malignant intracranial germ tumors, usually found in suprasellar regions. Less than 10% are localized in off-middle structures, and synchronous involvement of both structures has only exceptionally been published. A case of an 18-year-old male patient with progressive right-sided hemiparesis and panhypopituitarism was reviewed. Brain MRI showed a solid mass involving pituitary and hypothalamus with thickening of pituitary stalk, high intensity lesions on T2-weighted imaging in left internal capsule, caudate nucleus, globus pallidus, and mild atrophy of the left internal capsule and cerebral peduncle. Nonadenomatous lesions were considered in the differential diagnosis. Alfa-fetoprotein (AFP) levels were negative in both serum and cerebrospinal fluid (CSF), while β-human chorionic gonadotrophin (β-HCG) levels were slightly increased in CSF. A transsphenoidal biopsy identified a germinoma. Four cycles of chemotherapy with bleomicine, etoposide, and cysplatin were given, followed by radiotherapy, but patients died due to a recidiva. Conclusion. Germinoma must be considered in patients with insipidus diabetes with a sellar mass with thickening of pituitary stalk; and ectopic germinoma must be suspected in patients with slowly progressive hemiparesis with cerebral hemiatrophy. Even with a rare condition, colocalization of midline and off-midline germinoma must be suspected in the presence of these typical signs of both localizations. |
| format | Article |
| id | doaj-art-6547b3df53bb472c8f3c86639f905a1c |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
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| series | Case Reports in Endocrinology |
| spelling | doaj-art-6547b3df53bb472c8f3c86639f905a1c2025-02-03T01:21:37ZengWileyCase Reports in Endocrinology2090-65012090-651X2014-01-01201410.1155/2014/936937936937Germinoma with Involvement of Midline and Off-Midline Intracranial StructuresMonica Graciela Loto0Karina Danilowicz1Santiago González Abbati2Rafael Torino3Alejandro Misiunas4Division of Endocrinology, Metabolism, Nutrition and Diabetes, 1828 Caseros Avenue, 1152 Buenos Aires, ArgentinaDivision of Endocrinology, Metabolism, Nutrition and Diabetes, 1828 Caseros Avenue, 1152 Buenos Aires, ArgentinaDepartment of Neurosurgery, British Hospital, 1828 Caseros Avenue, 1152 Buenos Aires, ArgentinaDepartment of Neurosurgery, British Hospital, 1828 Caseros Avenue, 1152 Buenos Aires, ArgentinaDivision of Endocrinology, Metabolism, Nutrition and Diabetes, 1828 Caseros Avenue, 1152 Buenos Aires, ArgentinaGerminomas are malignant intracranial germ tumors, usually found in suprasellar regions. Less than 10% are localized in off-middle structures, and synchronous involvement of both structures has only exceptionally been published. A case of an 18-year-old male patient with progressive right-sided hemiparesis and panhypopituitarism was reviewed. Brain MRI showed a solid mass involving pituitary and hypothalamus with thickening of pituitary stalk, high intensity lesions on T2-weighted imaging in left internal capsule, caudate nucleus, globus pallidus, and mild atrophy of the left internal capsule and cerebral peduncle. Nonadenomatous lesions were considered in the differential diagnosis. Alfa-fetoprotein (AFP) levels were negative in both serum and cerebrospinal fluid (CSF), while β-human chorionic gonadotrophin (β-HCG) levels were slightly increased in CSF. A transsphenoidal biopsy identified a germinoma. Four cycles of chemotherapy with bleomicine, etoposide, and cysplatin were given, followed by radiotherapy, but patients died due to a recidiva. Conclusion. Germinoma must be considered in patients with insipidus diabetes with a sellar mass with thickening of pituitary stalk; and ectopic germinoma must be suspected in patients with slowly progressive hemiparesis with cerebral hemiatrophy. Even with a rare condition, colocalization of midline and off-midline germinoma must be suspected in the presence of these typical signs of both localizations.http://dx.doi.org/10.1155/2014/936937 |
| spellingShingle | Monica Graciela Loto Karina Danilowicz Santiago González Abbati Rafael Torino Alejandro Misiunas Germinoma with Involvement of Midline and Off-Midline Intracranial Structures Case Reports in Endocrinology |
| title | Germinoma with Involvement of Midline and Off-Midline Intracranial Structures |
| title_full | Germinoma with Involvement of Midline and Off-Midline Intracranial Structures |
| title_fullStr | Germinoma with Involvement of Midline and Off-Midline Intracranial Structures |
| title_full_unstemmed | Germinoma with Involvement of Midline and Off-Midline Intracranial Structures |
| title_short | Germinoma with Involvement of Midline and Off-Midline Intracranial Structures |
| title_sort | germinoma with involvement of midline and off midline intracranial structures |
| url | http://dx.doi.org/10.1155/2014/936937 |
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