title: Clinical diagnostic dilemma of intracranial germinoma manifesting as wide skull base extension.
abstract: OBJECTIVE
  The aims of this study were to present an uncommon intracranial germinoma manifesting as skull base extension and analyze its clinical characteristics to give valuable insight into such uncommon radiologic variant.
  
  
  METHODS
  This is a clinical study of a 15-year-old girl with intracranial germinoma manifesting as skull base extension. Clinical characteristics, magnetic resonance imaging scan observations, pathologic findings, and flow of the treatment procedure were presented and analyzed.
  
  
  RESULTS
  She had a 5-month history of diuresis and diplopia. magnetic resonance imaging observation displayed a neoplasm located in the right-side central skull base and suprasellar area with wide extension into the cavernous sinus, intraorbital region, ethmoidal sinus, sphenoid sinus, and pituitary fossa. After administration of contrast medium, strong and heterogeneous enhancement of the mass was observed, with a dural tail sign along the right cerebellar tentorial. Right pterional approach was performed, and intraoperative histologic examination suspected the diagnosis of germinoma; partial resection was achieved, and postoperative radiotherapy was administered. Cranial nerve palsy improved greatly 6 months postoperatively.
  
  
  CONCLUSIONS
  Although highly unusual, germinoma should be included in the differential diagnosis of all masses with extension along the midline region of skull base, especially when it happens in young female patients.
authors.affiliation: From the *Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing, China; †Key Laboratory of Tumor Immunopathology, Ministry of Education of China, Third Military Medical University, Chongqing, China; and ‡Institute of Neurosurgery, Chinese PLA General Hospital, Beijing, China.
authors.forename: Zhi-hang
authors.initials: ZH
authors.lastname: Zhou
authors.forename: Hai-bo
authors.initials: HB
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Rao
authors.forename: Xiu-wu
authors.initials: XW
authors.lastname: Bian
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D018237:Germinoma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019292:Skull Base Neoplasms / Q000175:diagnosis*