Basal ganglia germinoma: diagnostic value of MR spectroscopy and (11)C-methionine positron emission tomography.
We herein report a 12-year-old girl with a basal ganglia germinoma who presented with right-sided hemiparesis after a minor head trauma. Magnetic resonance (MR) imaging revealed a minimally enhanced lesion involving the left putamen, thalamus, and corona radiata. The lesion showed low-signal intensity on T1-, and high intensity on T2- and diffusion-weighted imaging. The MR signal in the adjacent globus pallidum was also low on T2-weighted imaging. MR spectroscopy on the lesion showed a large lactate/lipid/macromolecule peak with a decreased NAA/Cr ratio, but no increase in the Cho/Cr ratio. However, posttraumatic infarction at the territory of lateral lenticulostriate artery was ruled out 1 month later. This was based on progression of the hemiparesis and neuroimaging results, including an increased Cho/Cr ratio and weak uptake on (11)C-methionine positron emission tomography of the basal ganglia lesion. Stereotaxic brain biopsy confirmed the diagnosis of germinoma.
Fujii
Yuji
Y
Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan. yujinn0728@ybb.ne.jp
Saito
Yoshiaki
Y
Ogawa
Toshihide
T
Fujii
Shinya
S
Kamitani
Hideki
H
Kondo
Shinji
S
Horie
Yasushi
Y
Togawa
Masami
M
Senda
Michio
M
Maegaki
Yoshihiro
Y
Ohno
Kousaku
K
D001479:Basal Ganglia / Q000473:pathology*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000175:diagnosis*; D002250:Carbon Radioisotopes; D002648:Child; D005260:Female; D018237:Germinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008715:Methionine; D049268:Positron-Emission Tomography / Q000379:methods*
D002250:Carbon Radioisotopes; D008715:Methionine