[Pineal teratoma--case report (author's transl)]

A 3-year-old boy had a history of nausea and vomiting for 1 month. After two episodes of tonic cramp, he became drowsy and then semicomatous. Physical examination on admission revealed a dehydrated semicomatous boy with fixed, dilated pupils of equal size, horizontal nystagmus, and left hemiparesis with bilateral Babinski signs. Plain skull films showed a separation of coronal and sagittal sutures. A high density area surrounded by cyst was found in the pineal region in CT scan. Angiography demonstrated stretching of the posterior choroidal arteries, backward displacement of the Galen, the posterior mesencephalic and the precentral vein. The right occipital transtentorial approach was selected to remove the tumor totally. Histology revealed epidermis, hair follicle, sebaceus and sweat glands, columar gland, bone, cartilage, muscle, fatty tissue, nervous tissue, and connective tissue, indicating a pineal teratoma. There was no evidence of germinoma.