Intrasellar and suprasellar germinoma

A 15-year-old male was admitted to our hospital with diabetes insipidus, headache and bitemporal hemianopia and a computed tomogram (CT) revealed an intra- and suprasellar tumor. Differential diagnosis between large intra- and suprasellar germinoma and pituitary adenomas is quite difficult based on CT. After comparing our case with past literature of reported cases of intrasellar and suprasellar germinoma, we found that an enhanced mass posterior to the pituitary gland on the midsagittal magnetic resonance imaging (MRI) and absence of the high signal intensity of the posterior lobe on T1-weighted MRI in patients with diabetes insipidus indicated germinoma rather than a pituitary adenoma. Transphenoid approach and appropriate radiotherapeutic management were administered with a good result.