Case ReportsBasal ganglia germinoma with progressive cerebral hemiatrophy
Introduction
Germinomas, which are believed to arise from the primordial germ cells, are the least malignant and most common of all germ cell tumors, a category that also includes embryonal cell carcinomas, endodermal sinus tumors, choriocarcinomas, and teratomas [1]. Germinomas represent 0.5-2.1% of all intracranial tumors and have a peak incidence in the latter half of the second decade [2]. Most of these tumors are found at the midline in the pineal or suprasellar regions. The authors present a case of an off-midline germinoma with progressive cerebral hemiatrophy.
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Case report
A 7-year-old, previously healthy and developmentally normal, right-handed Chinese-American female developed a slowly progressive right-sided hemiparesis. Two months after the onset of these symptoms, computed tomography (not shown) revealed mineralization of the left globus palidus and expansion of the frontal horn of the left lateral ventricle, indicating tissue loss. Magnetic resonance imaging (MRI) revealed volume loss of the left caudate head and abnormal T2-weighted signal within the
Discussion
Although central nervous system (CNS) germinomas usually occur at the midline, several reports from Asian countries have found that up to 14% of these tumors arise within the basal ganglia or thalamus [2], [3], a geographic bias consistent with the Chinese background of the authors’ patient. A recent review of 42 cases also revealed a strong sex and age bias, with a male/female ratio of 20:1, with all patients between 6 and 20 years of age [2]. As was the case with the authors’ patient, these
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Cited by (39)
Pediatric Basal Ganglia Region Tumors: Clinical and Radiologic Features Correlated with Histopathologic Findings
2017, World NeurosurgeryCitation Excerpt :In MRI, such tumors present as an ill-defined, heterogeneous enhancing mass with or without a cystic component.22-24 Hemiatrophy has been considered as a diagnostic sign and was observed in 9 cases (81.8%) in our series.25,26 Because the GCTs are not as rare as predicted, we recommend routine examination of tumor markers, including AFP and β-HCG, for patients with PGBRTs.
Clinical and Radiologic Features of Pediatric Basal Ganglia Germ Cell Tumors
2016, World NeurosurgeryCitation Excerpt :2) After reviewing our series and the previous reported cases, we observed that basal ganglia GCTs are predominantly located in the caput of caudate nucleus adjacent to the anterior horn of lateral ventricles. 3) Ipsilateral hemiatrophy has been considered as a diagnostic sign of basal ganglia GCTs, especially in the early stage.3,14-17 In our series, hemiatrophy was observed in 8 cases (66.7%) and occurred predominantly in ipsilateral cerebral peduncle, which probably because that most of the tumors enrolled in our study were large lesions associated with significant mass effect and subsequently occupied the subarachnoid space.
Basal Ganglia Germinoma in an Adult
2016, World NeurosurgeryCitation Excerpt :The features of basal ganglia germinoma on MRI are unremarkable; however, ipsilateral hemispheric brain atrophy was present in 12 of 29 patients (41%).8,14,15 Radiological studies have demonstrated that parenchymal atrophy is attributable to Wallerian degeneration.20,21 CNS metastasis is rare.
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2006, Seminars in Arthritis and RheumatismRight Basal Ganglia Germinoma: Case Report and Literature Review
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