[A case of large germinoma in bilateral frontal region (author's transl)]

Though most of ectopic pinealoma occurs in the midline of cerebral base, only ten cases of frontal subcortical germinomas were reported in Japan as far as we know in literature. The patient, 20 year-old male, was admitted to our hospital because of blurred vision of the right eye and somnolence. Neurological examination on admission revealed bilateral choked discs and impaired visual acuity of both eyes with visual field defect of the right eye. A large deep bifrontal tumor was noted by cerebral angiography and pneumoventriculography done at the time of ventricular drainage. After subtotal removal of left frontal tumor and bifrontal V-P shunt, he came alert. No abnormality of posterior part of third ventricle was noted on the post-operative pneumonencephalogram. As the microscopic examination revealed that the tumor was germinoma of two-cell pattern, Co60 with a total dose of 5,900 rads was irradiated to the rest of the tumor. Brain scan with Tc99m 6 months after the surgery showed the disappearance of the tumor and CT scan 3 years later confirmed no recurrence of the tumor. Fine structure of the tumor was also presented and discussed.