Metastatic primary bifocal germinoma of the brain

Intracranial germ cell tumors are relatively rare. They can affect the pineal region of the brain or the suprasellar area, or both simultaneously, and can cause various complications as well as endocrinological disorders. These tumors are characterized by their aggressive behavior and the tendency to metastasize. Intracranial germ cell tumors require an interdisciplinary approach in order to determine the most appropriate management. Radiotherapy and chemotherapy form the backbone of treatment strategies. Surgical methods are not the standard of care for this type of pathology, but they can provide histological confirmation in cases where tumor markers are not significant and can also be considered when seeking immediate symptomatic control. This study presents a juvenile case of a bifocal primary brain germinoma in which a liver metastasis was found after initial brain surgery and radiation therapy. The complex treatment continued with liver metastasectomy and chemotherapy, with the result of a complete therapeutic response and no recurrence after more than seven years of follow-up.