Pineal germinoma with massive supratentorial extension. Case report

Area of Science:

• Neuro-oncology
• Neurosurgery
• Radiology

Background:

• Pineal germinomas are rare tumors, often presenting with obstructive hydrocephalus.
• This case highlights an unusual presentation of a large pineal germinoma without ventricular enlargement.

Observation:

• The tumor exhibited a dumbbell-shaped supratentorial extension, involving both cerebral hemispheres.
• Neuroradiological examinations suggested a glioma due to the tumor's morphology and location.

Findings:

• Subtotal tumor removal via a bilateral parieto-occipital approach was performed.
• Adjuvant radiation therapy was administered post-operatively.

Implications:

• This case underscores the importance of considering germinomas in the differential diagnosis of supratentorial masses, even without typical hydrocephalus.
• The findings emphasize the potential for misleading radiological appearances in pineal region tumors.
• Successful management involved a multimodal approach, achieving prolonged symptom relief.