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Sequential MRI findings in a patient with a germ cell tumor in the basal ganglia
1Department of Pediatrics, Shiga University of Medical Science, Ohtsu, Japan.
Abstract:
Serial changes of MRI scanning of an 11-year-old boy with hemiparesis due to a germ cell tumor in the basal ganglia are presented. Initial brain MRI T1-weighted images revealed a subtle mixed signal intensity lesion at left anterior and posterior limbs of the internal capsule. This lesion was not enhanced with Gd-DTPA, however, T2-weighted images showed a misty high signal intensity lesion in the same region. The MR images also showed hemiatrophy of the left basal ganglia. Histologic examination of biopsy specimens of the tumor revealed an embryonal carcinoma. The patient was treated with chemotherapy with subsequent improvement in the hemiparesis. Our case suggests that germ cell tumors must be considered in the differential disorders of lesions in the ipsilateral hemiatrophic basal ganglia in pediatric patients with hemiparesis.
Insights
Germ cell tumors can cause hemiparesis in children. MRI revealed a basal ganglia tumor with hemiatrophy, which improved with chemotherapy.
Area of Science:
- Neuro-oncology
- Pediatric Neurology
- Diagnostic Imaging
Background:
- Germ cell tumors (GCTs) are rare in the basal ganglia.
- Hemiparesis in children can have various causes, including neoplastic lesions.
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing brain lesions.
Observation:
- Serial MRI scans of an 11-year-old boy with hemiparesis were analyzed.
- Initial MRI showed a subtle, non-enhancing lesion in the left internal capsule with high T2 signal intensity.
- Associated findings included hemiatrophy of the left basal ganglia.
Findings:
- Histopathology confirmed the lesion as an embryonal carcinoma, a type of GCT.
- Chemotherapy led to clinical improvement in the patient's hemiparesis.
- The MRI findings, including hemiatrophy, were associated with the GCT.
Implications:
- GCTs should be considered in the differential diagnosis of pediatric basal ganglia lesions presenting with hemiparesis.
- Early diagnosis and treatment of GCTs are essential for favorable outcomes.
- This case highlights the utility of MRI in identifying and characterizing GCTs in pediatric patients.