Primary midbrain cystic germinoma mimicking glioma: a case with neuroendoscopic biopsy.
Intracranial germinoma arising primarily in the midbrain is extremely rare. We present the first reported case of cystic midbrain germinoma that lacked evident solid components and mimicked a midbrain glioma. In a 22-year-old man with headache and diplopia, magnetic resonance imaging showed a ring-enhancing lesion in the midbrain. The preoperative diagnosis included brain stem glioma, metastasis, and neuroepithelial cyst. A neuroendoscopic biopsy specimen provided a histologic diagnosis of germinoma. The patient responded well to chemotherapy and radiotherapy. The case illustrates the diagnostic value of neuroendoscopic biopsy in the differential diagnosis of brainstem lesions in adult. The possibilities considered should now include germinoma.
Department of Neurosurgery, Saiseikai Yokohama-shi Nambu Hospital, Yokohama-shi, Kanagawa-ken, Japan. uchino0717@yahoo.co.jp
Masafumi
M
Uchino
Daisuke
D
Haga
Toshiaki
T
Mito
Tohru
T
Kuramitsu
Noriko
N
Nakamura
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D020295:Brain Stem Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D003937:Diagnosis, Differential; D004172:Diplopia / Q000209:etiology; D004724:Endoscopy; D018237:Germinoma / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005910:Glioma / Q000473:pathology*; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male