title: Germ cell tumor presenting as sellar mass with suprasellar extension and long history of hypopituitarism.
abstract: OBJECTIVE
  Primary central nervous system germ cell tumors are rare neoplasms usually located in the pineal and/or suprasellar region. Pure germinomas do not usually secrete beta-human chorionic gonadotropin hormone (beta-HCG) or alpha-fetoprotein (AFP) and diagnosis is made a few weeks or months after beginning of symptoms.
  
  
  METHODS
  Here we report a case of a pure germinoma in a 20 year-old woman presenting as a sellar mass with suprasellar extension, abnormal serum beta-HCG and a long history of polyuria and polydipsia (4 years), that was initially diagnosed as a pituitary macroadenoma.
  
  
  CONCLUSIONS
  This presentation highlights the importance of thinking in alternative diagnosis to pituitary adenoma when diabetes insipidus is the initial symptom.
authors.affiliation: Department of Endocrinology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. mgadelha@hucff.ufrj.br
authors.forename: Leandro Kasuki Jomori
authors.initials: LK
authors.lastname: de Pinho
authors.forename: Leonardo Vieira
authors.initials: LV
authors.lastname: Neto
authors.forename: Leila Maria
authors.initials: LM
authors.lastname: Cardão Chimelli
authors.forename: Emerson Leandro
authors.initials: EL
authors.lastname: Gasparetto
authors.forename: Leila
authors.initials: L
authors.lastname: Warszawski
authors.forename: Antônio Aversa Dutra
authors.initials: AA
authors.lastname: do Souto
authors.forename: Mônica R
authors.initials: MR
authors.lastname: Gadelha
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D018237:Germinoma / Q000150:complications / Q000473:pathology*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications*; D010911:Pituitary Neoplasms / Q000150:complications / Q000473:pathology*; D012658:Sella Turcica / Q000473:pathology*; D055815:Young Adult