title: Mixed germ cell tumor of the midbrain. Case Report.
abstract: This 14-year-old boy presented with left hemiparesis, gait disturbance, and multiple cranial nerve palsies. Magnetic resonance imaging revealed a multicystic mass with hemorrhagic fluid-fluid levels in the right midbrain, suggesting the presence of a cavernous malformation. Diffusion tensor imaging showed the mass to be close to the right corticospinal tract and ipsilateral medial lemniscus. Subtotal removal of the mass was performed via a right subtemporal approach. The histopathological diagnosis was of a mixed germ cell tumor (GCT) comprising mature teratoma and germinoma cells with syncytiotrophoblastic giant cells. The patient underwent postoperative chemotherapy and radiotherapy, and no tumor progression was found during 1 year of follow-up. Intracranial GCTs arise mainly in the pineal and the suprasellar area. Germ cell tumors in the brainstem are rare, with only 12 reported cases. Among these, 4 were in the midbrain and histologically were pure germinomas. To the authors' knowledge, this is the first reported case of a mixed GCT in the midbrain combining mature teratoma and germinoma cells.
authors: Division of Pediatric Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Eun Jung
authors: EJ
authors: Koh
authors: Ji Hoon
authors: JH
authors: Phi
authors: Sung-Hye
authors: SH
authors: Park
authors: In-One
authors: IO
authors: Kim
authors: Jung-Eun
authors: JE
authors: Cheon
authors: Kyu-Chang
authors: KC
authors: Wang
authors: Byung-Kyu
authors: BK
authors: Cho
authors: Seung-Ki
authors: SK
authors: Kim
mesh_terms: D000293:Adolescent; D020295:Brain Stem Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis* / Q000628:therapy*