Brain germinoma in a young adult man with suspicion of fatal neglect.
We report a forensic autopsy case of brain germinoma in a 26-year-old man who was severely wasted and initially suspected of fatal neglect. He had a history of nocturnal wandering and was confined by his parents. Neuropathological examination showed germinoma in the hypothalamus and neurohypophysis. The cause of death was certified as hypothalamo-hypophyseal insufficiency due to germinoma. Because hypothalamic lesions may dysregulate feeding behavior and sleeping rhythms, germinoma was considered the causative lesion of the anorexic wasting and nocturnal wandering. Confinement was a preventive measure of the patient's wandering. The findings in this case indicated that hypothalamic tumors should be recognized as a cause of wasting in autopsies suspected of fatal neglect.
Kibayashi
Kazuhiko
K
Department of Legal Medicine, Tokyo Women's Medical University, Japan. kibayash@research.twmu.ac.jp
Sugita
Yasuo
Y
Shojo
Hideki
H
Sumida
Tomomi
T
D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology*; D049429:Forensic Pathology; D018237:Germinoma / Q000150:complications / Q000473:pathology*; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000209:etiology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D013009:Somnambulism / Q000209:etiology / Q000503:physiopathology; D019282:Wasting Syndrome / Q000209:etiology / Q000503:physiopathology