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Germinoma with Diffuse Subependymal Spread: A Case Report.

Evan M Krueger1, Darbi L Invergo1, Julian J Lin2

  • 1Neurosurgery, Advocate Health Care.

Cureus
|July 20, 2016
PubMed
Summary
This summary is machine-generated.

A rare pure germinoma presented with diffuse ventricular seeding, mimicking other pathologies. Prompt diagnosis and radiation therapy led to significant clinical improvement and tumor burden reduction.

Keywords:
diffuse subependymalintracranial germinomapinealsuprasellarventricles

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Area of Science:

  • Neuro-oncology
  • Pediatric Neurology
  • Radiology

Background:

  • Germinomas are rare germ cell tumors, more prevalent in Asian populations.
  • They typically present as midline masses, with diffuse ventricular seeding being uncommon.

Observation:

  • A 19-year-old male presented with headaches and syncope, showing pineal/suprasellar masses and diffuse subependymal enhancement on imaging.
  • Cerebrospinal fluid analysis was non-specific, necessitating further investigation.

Findings:

  • Neuroendoscopic biopsy confirmed a pure germinoma.
  • The patient showed significant clinical improvement and tumor regression after radiation therapy.

Implications:

  • This case highlights the importance of considering germinoma in cases of diffuse subependymal lesions, even with negative tumor markers in CSF.
  • Histopathologic diagnosis via endoscopic biopsy is crucial for definitive diagnosis in the US.
  • Germinomas demonstrate high sensitivity to radiation and chemotherapy, offering a favorable prognosis.