Occurrence of basal ganglia germ cell tumors without a mass.
OBJECTIVE
To report a case series in which basal ganglia calcifications without mass effect proved to be germ cell tumors.


METHODS
Case series.


METHODS
Tertiary care hospital.


METHODS
Four patients.


METHODS
Computed tomography, magnetic resonance imaging, positron emission tomography, biopsy, chemotherapy, and radiation therapy.


METHODS
Recognition of clinical syndrome and radiological features.


RESULTS
All patients had progressive hemiparesis, and 1 patient also had frontal lobe dementia. Imaging demonstrated progressive asymmetric signal abnormality with basal ganglia calcification and associated brainstem atrophy. Fludeoxyglucose F 18-positron emission tomography showed hypometabolism in contrast to malignant glioma.


CONCLUSIONS
Germ cell tumor should be considered in patients with an indolently progressive neurological course, particularly if basal ganglia calcification is present with or without enhancement, asymmetric brain atrophy, or a mass.
Almubarak
Salah
S
Division of Neurology, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
Gan
Yee-Chiung
YC
Steinbok
Paul
P
Hendson
Glenda
G
Poskitt
Ken
K
Nadel
Helen
H
Goddard
Karen
K
Hukin
Juliette
J
D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use; D044466:Asian People; D001284:Atrophy / Q000209:etiology / Q000473:pathology; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D001480:Basal Ganglia Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D001933:Brain Stem / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D002648:Child; D003704:Dementia / Q000209:etiology; D018450:Disease Progression; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D010291:Paresis / Q000209:etiology; D049268:Positron-Emission Tomography; D011878:Radiotherapy
D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18