Radiological features of basal ganglia germinoma: a case report and early-stage alerts

Basal ganglia germinomas are uncommon neoplasms. Basal ganglia germinomas exhibit high sensitivity to both radiation therapy and chemotherapy. In contrast, surgery is the standard treatment for most primary brain tumors (such as gliomas, which are the most common tumors in the pediatric basal ganglia region). A 21-year-old male patient was admitted to our hospital because of unexplained right-sided hemiparesis for two years. Biomarkers indicating germ cell tumors are typically negative. On the initial MRI, the abnormalities were nonspecific, causing no suspicion of a tumor. Therefore, the patient did not receive an earlier diagnosis or treatment. His brain MRI revealed a mass with more apparent features one year later. Based on the imaging characteristics of conventional and advanced MR images, the preoperative radiological diagnosis was highly likely to reveal germinomas. The patient then underwent a biopsy and received appropriate treatment. Despite treatment, his symptoms only partially improved. Accurate preoperative diagnosis is crucial for ensuring that patients receive appropriate treatment and to help avoid more invasive surgery. Additionally, early identification of germinomas is also important for improving long-term patient outcomes and preventing tumor spread due to delayed diagnosis. Therefore, we aim to review and report this case to assist radiologists in recognizing and becoming familiar with the early imaging signs of basal ganglia germinoma.