title: Primary germinoma in the medulla oblongata - case report - .
abstract: A 27-year-old woman presented with a case of primary medulla oblongata germinoma manifesting as sleep apnea, aspiration pneumonia, and left hemiparesis. Magnetic resonance (MR) imaging revealed a dorsal mass in the medulla oblongata with heterogeneous enhancement by gadolinium (Gd). Emergent biopsy and foramen magnum decompression with C1 laminectomy were performed because of rapid worsening of her symptoms. The histological diagnosis was germinoma. Subsequently she received chemoradiation therapy with subsequent amelioration of her neurological deficits and disappearance of enhancement on MR imaging with Gd. Primary medulla oblongata germinoma is rare and difficult to diagnose preoperatively. However, correct diagnosis and subsequent adequate chemoradiation therapy is possible by understanding the common characteristics of the disease. Germinoma should be included in the differential diagnosis of midline medullary lesion in young patients, and biopsy should be considered.
authors.affiliation: Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. tyasu37@cc.okayama-u.ac.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Yasuhara
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kurozumi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Maruo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yanai
authors.forename: Isao
authors.initials: I
authors.lastname: Date
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D005260:Female; D005539:Foramen Magnum / Q000601:surgery; D018237:Germinoma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000473:pathology*; D016896:Treatment Outcome