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Published on: January 17, 2018
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Intracranial lobar germinoma presenting with refractory hypernatremia
Mahak Sipani1, Gyani Jail Singh Birua2, Abhinith Shashidhar1
1Department of Neurosurgery, Neuro-Center Building, National Institute of Mental Health & Neurosciences (NIMHANS), 29, Bengaluru, Karnataka, 560029, India.
Summary
This study reports a rare case of eccentric central nervous system germinoma in a 14-year-old boy, presenting with diabetes insipidus. The tumor was successfully treated with surgery and desmopressin, highlighting a unique presentation without sellar involvement.
Area of Science:
- Neuro-oncology
- Pediatric Endocrinology
Background:
- Central nervous system germ cell tumors typically arise in midline structures.
- Eccentric germinomas, though rare, can occur in various brain locations, including the basal ganglia and cranial vault.
Observation:
- A 14-year-old male presented with symptoms of diabetes insipidus and was initially diagnosed with a left frontal high-grade glioma via imaging.
- Histopathology confirmed the diagnosis as germinoma.
Findings:
- The patient experienced resolution of hypernatremia after surgical intervention.
- Normal sodium homeostasis was maintained with a low dose of desmopressin post-surgery.
Implications:
- This case highlights an unusual presentation of an eccentric central nervous system germinoma.
- It underscores the importance of considering germinoma in the differential diagnosis of pediatric patients with diabetes insipidus, even without apparent sellar or suprasellar lesions.
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