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Germinoma with Diffuse Subependymal Spread: A Case Report
A 19-year-old Caucasian male presented with complaints of headaches and syncope. Suspicion of hydrocephalus prompted computed tomography (CT) and magnetic resonance imaging (MRI), which revealed pineal and suprasellar prominences with diffuse, thick, nodular subependymal enhancement of the lateral a...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946958/ https://www.ncbi.nlm.nih.gov/pubmed/27433421 http://dx.doi.org/10.7759/cureus.643 |
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author | Krueger, Evan M Invergo, Darbi L Lin, Julian J |
author_facet | Krueger, Evan M Invergo, Darbi L Lin, Julian J |
author_sort | Krueger, Evan M |
collection | PubMed |
description | A 19-year-old Caucasian male presented with complaints of headaches and syncope. Suspicion of hydrocephalus prompted computed tomography (CT) and magnetic resonance imaging (MRI), which revealed pineal and suprasellar prominences with diffuse, thick, nodular subependymal enhancement of the lateral and third ventricles. Based on imaging, the differential diagnosis consisted primarily of malignancy, such as lymphoma, with inflammatory and infectious etiologies not excluded. Cerebrospinal fluid (CSF) samples were non-specific, and neuroendoscopic tissue biopsy histologically confirmed the diagnosis of pure germinoma. The patient was treated with radiation, and follow-up MRIs at one, three, six, and 12 months demonstrated progressive resolution of tumor burden with marked clinical improvement. Germinomas are rare germ cell tumors that are more frequently diagnosed in Asian countries. They uncommonly seed into the lateral ventricles, and only two other cases have been described with diffuse subependymal involvement. Unlike other malignant germ cell tumors, germinomas have marker negative CSF samples that are important in the normal diagnostic workup of diffuse subependymal lesions. Histopathologic correlation is required for definitive diagnosis in the United States and can be achieved with endoscopic tissue sampling. Germinomas are highly radio- and chemotherapy sensitive and have a fair prognosis with modern therapeutic techniques. Germinoma should be considered with simultaneous midline and diffuse ventricular lesions. |
format | Online Article Text |
id | pubmed-4946958 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-49469582016-07-18 Germinoma with Diffuse Subependymal Spread: A Case Report Krueger, Evan M Invergo, Darbi L Lin, Julian J Cureus Neurosurgery A 19-year-old Caucasian male presented with complaints of headaches and syncope. Suspicion of hydrocephalus prompted computed tomography (CT) and magnetic resonance imaging (MRI), which revealed pineal and suprasellar prominences with diffuse, thick, nodular subependymal enhancement of the lateral and third ventricles. Based on imaging, the differential diagnosis consisted primarily of malignancy, such as lymphoma, with inflammatory and infectious etiologies not excluded. Cerebrospinal fluid (CSF) samples were non-specific, and neuroendoscopic tissue biopsy histologically confirmed the diagnosis of pure germinoma. The patient was treated with radiation, and follow-up MRIs at one, three, six, and 12 months demonstrated progressive resolution of tumor burden with marked clinical improvement. Germinomas are rare germ cell tumors that are more frequently diagnosed in Asian countries. They uncommonly seed into the lateral ventricles, and only two other cases have been described with diffuse subependymal involvement. Unlike other malignant germ cell tumors, germinomas have marker negative CSF samples that are important in the normal diagnostic workup of diffuse subependymal lesions. Histopathologic correlation is required for definitive diagnosis in the United States and can be achieved with endoscopic tissue sampling. Germinomas are highly radio- and chemotherapy sensitive and have a fair prognosis with modern therapeutic techniques. Germinoma should be considered with simultaneous midline and diffuse ventricular lesions. Cureus 2016-06-15 /pmc/articles/PMC4946958/ /pubmed/27433421 http://dx.doi.org/10.7759/cureus.643 Text en Copyright © 2016, Krueger et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Neurosurgery Krueger, Evan M Invergo, Darbi L Lin, Julian J Germinoma with Diffuse Subependymal Spread: A Case Report |
title | Germinoma with Diffuse Subependymal Spread: A Case Report |
title_full | Germinoma with Diffuse Subependymal Spread: A Case Report |
title_fullStr | Germinoma with Diffuse Subependymal Spread: A Case Report |
title_full_unstemmed | Germinoma with Diffuse Subependymal Spread: A Case Report |
title_short | Germinoma with Diffuse Subependymal Spread: A Case Report |
title_sort | germinoma with diffuse subependymal spread: a case report |
topic | Neurosurgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946958/ https://www.ncbi.nlm.nih.gov/pubmed/27433421 http://dx.doi.org/10.7759/cureus.643 |
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