title: Metastasis germinomas of the external acoustic meatus: in a 19-year-boy: a case report.
abstract: BACKGROUND
  The external acoustic meatus metastasis of germinomas is a rare event.
  
  
  METHODS
  we describe a 19-year-old boy with stuffiness and earplug of the left ear but no other symptoms. The whole body F-18 FDG PET/CT and the brain MRI are performed and demonstrated a germinoma in the pineal gland and vermis cerebellum region and in the right of thalamus. Photomicrograph showing marked infiltration of lymphoplasma cells and macrophages including giant cells. Immunohistochemical analysis results demonstrated the tumor cells are strongly positive for CD117 and PLAP. The final diagnosis was germinoma and all adjuvant therapy was achieved.
  
  
  CONCLUSIONS
  Although the external acoustic meatus metastasis of germinomas is rare, the diagnosis should be taken into serious consideration in order to improve. In addition, F-18 FDG PET/CT was very useful in diagnosis primary disease and excluding distant metastases. To our knowledge, this is the first published report of this type of case.
authors.affiliation: Department of Nuclear Medicine, Urumqi General Hospital of Lanzhou Military Region, Urumqi, Xinjiang, 830002, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhao
authors.forename: Jiang
authors.initials: J
authors.lastname: Wang
authors.forename: Ya
authors.initials: Y
authors.lastname: Ba
authors.forename: Qiong
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D001932:Brain Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D004424:Ear Canal / Q000737:chemistry / Q000473:pathology*; D004428:Ear Neoplasms / Q000737:chemistry / Q000556:secondary* / Q000628:therapy; D018237:Germinoma / Q000737:chemistry / Q000556:secondary* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011506:Proteins / Q000032:analysis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome; D051598:Whole Body Imaging
chemical_list: D014408:Biomarkers, Tumor; D011506:Proteins; C055324:phospholipase A2-activating protein; D019009:Proto-Oncogene Proteins c-kit
keywords: F-18 FDG PET/CT; Germinomas; external acoustic meatus; immunohischemistry