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Occurrence of basal ganglia germ cell tumors without a mass
Salah Almubarak1, Yee-Chiung Gan, Paul Steinbok
1Division of Neurology, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
Objective:
To report a case series in which basal ganglia calcifications without mass effect proved to be germ cell tumors.
Design:
Case series.
Setting:
Tertiary care hospital.
Patients:
Four patients.
Interventions:
Computed tomography, magnetic resonance imaging, positron emission tomography, biopsy, chemotherapy, and radiation therapy.
Main Outcome Measures:
Recognition of clinical syndrome and radiological features.
Results:
All patients had progressive hemiparesis, and 1 patient also had frontal lobe dementia. Imaging demonstrated progressive asymmetric signal abnormality with basal ganglia calcification and associated brainstem atrophy. Fludeoxyglucose F 18-positron emission tomography showed hypometabolism in contrast to malignant glioma.
Conclusion:
Germ cell tumor should be considered in patients with an indolently progressive neurological course, particularly if basal ganglia calcification is present with or without enhancement, asymmetric brain atrophy, or a mass.
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