Abstract
Introduction
Cerebral germinomas, the most common and least malignant intracranial germ cell tumors, usually arise in the pineal or suprasellar region and have characteristic clinical and radiological features. Germinomas more rarely occur in the thalamus, basal ganglia, and internal capsule, causing sometimes cerebral hemiatrophy and hemiparesis. More rarely, other clinical features can be fever of unknown origin, visual disturbance, and neuropsychiatric symptoms. Cerebral hemiatrophy can precede the imaging depiction of the off-midline mass.
Case
The authors present the first case of cerebral germinoma with synchronous involvement of the midline and off-midline structures, with unusual clinical and radiological presentation.
Discussion
The literature is reviewed, and the pathogenesis, the clinical findings, the imaging, and the therapy are discussed.
Similar content being viewed by others
References
Barkovich AJ (2005) Intracranial, orbital and neck masses of childhood. In: Pediatric neuroimaging, 4th edn. Williams and Wilkins, Philadelphia
Hadjikoutis S, Hughese T (2004) Germinoma with synchronous involvement of the pineal gland and the suprasellar region: a treatable cause of visual failure in a young adult. Eye 18(5):525–526
Higano S, Takahashi S, Ishii K, Matsumoto K, Ikeda H, Sakamoto K (1994) Germinoma originating in the basal ganglia and thalamus: MR and CT evaluation. AJNR AM J Neuroradiol 15:1435–1441
Kim DI, Yoon PH, Ryu YH, Jeon P, Hwang GJ (1998) MRI of germinomas arising from the basal ganglia and thalamus. Neuroradiology 40:507–511
Kim CH, Paek SH, Park IA, Chi JG, Kim DG (2002) Cerebral germinomas with hemiatrophy of the brain: report of three cases. Acta Neurochir 144:145–150
Kobayashi T, Kageyama N, Kida Y, Yoshida J, Shibuya N, Okamura K (1981) Unilateral germinomas involving the basal ganglia and thalamus. J Neurosurg 55:55–62
Komatsu Y, Narushima K, Kobayashi E et al (1989) CT and MR of germinoma in the basal ganglia. AJNR AM J Neuroradiol 10:S9–S11
Kwak R, Saso SI, Suzuki J (1978) Ipsilateral cerebral atrophy with thalamic tumor of childhood. Case report. J Neurosurg 48:443–449
Liang L, Korogi Y, Sugahara T et al (2002) MRI of intracranial germ-cell tumors. Neuroradiology 44:382–388
Lin Y, Gao P (1999) CT and MR imaging of germinomas arising in basal ganglia and thalamus. Zhonghua Yixue Zazhi 79(6):431–434
Liu E, Robertson RL, du Plessis A, Pomeroy SL (1999) Basal ganglia germinoma with progressive cerebral hemiatrophy. Pediatr Neurol 20:312–314
Matsutani S, Sano K, Takakura K et al (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86:446–455
Moon WK, Chang KH, Kim I-O et al (1994) Germinoma of the basal ganglia and thalamus: MR findings and comparison between MR and CT. AJR Am J Roentgenol 162:1413–1417
Okamoto K, Ito J, Ishikawa K et al (2002) Atrophy of the basal ganglia as the initial diagnostic sign of germinoma in the basal ganglia. Neuroradiology 44:389–394
Soejima T, Takeshita I, Yammamoto H, Tlukamoto Y, Fukui M, Matsuoka S (1987) CT of germinomas in basal ganglia and thalamus. Neuroradiology 29:366–370
Sudo A, Shiga T, Okajiama M, Takano K, Terae S, Sawamura Y, Ohnishi A, Nagashima K, Saitoh S (2003) High uptake on 11C-methionine positron emission tomographic scan of basal ganglia germinoma with cerebral hemiatrophy. Am J Neuroradiol 24(9):1909–1911
Tamaki N, Lin T, Shirataki K et al (1990) Germ cell tumors of the thalamus and basal ganglia. Childs Nerv Syst 6:3–7
Wong GJ, Hung KL, Huang JS, Chen TY (1999) Unilateral thalamic tumor with atrophy of ipsilateral cortical cortex: report of a case. J Formos Med Assoc 90(6):609–11,587
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sartori, S., Laverda, A.M., Calderone, M. et al. Germinoma with synchronous involvement of midline and off-midline structures associated with progressive hemiparesis and hemiatrophy in a young adult. Childs Nerv Syst 23, 1341–1345 (2007). https://doi.org/10.1007/s00381-007-0390-x
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-007-0390-x