title: Pineal germinoma presenting as anorexia nervosa: Case report and review of the literature.
abstract: OBJECTIVE
  Tumors of the hypothalamic-pineal region may present with a wide variety of symptoms, including disturbed eating. We present a case where such a tumor was misdiagnosed as anorexia nervosa.
  
  
  METHODS
  We describe a case of pineal germinoma invading the hypothalamus, which was initially diagnosed as anorexia nervosa.
  
  
  RESULTS
  Clinical features included weight loss, vomiting, pyrexia, hypernatraemia, and visual disturbance and the typical psychopathology of anorexia nervosa was absent.
  
  
  CONCLUSIONS
  Organic disorder should always be considered before making a diagnosis of anorexia nervosa, particularly if the presentation is atypical.
authors.affiliation: Eating Disorders Unit, Woodleigh Beeches Centre, Warwick Hospital, Warwick, United Kingdom. Anthony.Winston@SWarkPCT.nhs.uk
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Winston
authors.forename: Dan
authors.initials: D
authors.lastname: Barnard
authors.forename: Geraldine
authors.initials: G
authors.lastname: D'Souza
authors.forename: Amjad
authors.initials: A
authors.lastname: Shad
authors.forename: Khaled
authors.initials: K
authors.lastname: Sherlala
authors.forename: Jyoti
authors.initials: J
authors.lastname: Sidhu
authors.forename: Suraj Pal
authors.initials: SP
authors.lastname: Singh
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis*; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D018237:Germinoma / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D007031:Hypothalamus / Q000473:pathology / Q000528:radiation effects; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D010870:Pineal Gland / Q000473:pathology* / Q000528:radiation effects; D010871:Pinealoma / Q000473:pathology* / Q000532:radiotherapy