Atypical basal ganglia germinoma presenting as cerebral hemiatrophy: diagnosis and follow-up with 11C-methionine positron emission tomography.
OBJECTIVE
Some basal ganglia germinomas are difficult to diagnose in early stage of disease due to vague initial presentation without discernable mass lesion on brain imaging. We performed this study to determine the usefulness of 11C-methionine positron emission tomography (MET PET) for the diagnosis and monitoring of disease activity.


METHODS
MET PET was performed in three consecutive patients; they presented with cerebral hemiatrophy without definite mass lesions on brain image. The maximum standard tracer uptake values (max SUVs) were calculated and used for the quantitative evaluation of the abnormal MET uptake. A pathological diagnosis was made after stereotactic biopsy using MET PET/computed tomography. The max SUVs significantly decreased after treatment.


CONCLUSIONS
Basal ganglia germinoma should be considered in the differential diagnosis of patients with progressive hemiparesis and hemiatrophy on magnetic resonance imaging. The MET PET was useful for diagnosis, and it can be valuable in evaluation of treatment effects and monitoring for tumor recurrence.
Lee
Jeehun
J
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Lee
Bo Lyun
BL
Yoo
Keon Hee
KH
Sung
Ki Woong
KW
Koo
Hong Hoe
HH
Lee
Su Jin
SJ
Choi
Joon Young
JY
Lee
Kyung-Han
KH
Lee
Jung Il
JI
Shin
Hyung-Jin
HJ
Kim
Ji Hye
JH
Suh
Yeon Lim
YL
Lee
Ke Hyang
KH
Lee
Munhyang
M
D000293:Adolescent; D001284:Atrophy; D001479:Basal Ganglia / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000209:etiology; D002250:Carbon Radioisotopes; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D018237:Germinoma / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008715:Methionine; D049268:Positron-Emission Tomography / Q000379:methods
D002250:Carbon Radioisotopes; D008715:Methionine