title: Unusual cause of profound weight loss in a young woman.
abstract: A 27-year-old woman presented with anorexia, weight loss and psychiatric symptoms for the past 4 years. She did not have history of headache, visual disturbances or symptoms of raised intracranial pressure. She was sarcopenic with body mass index of 10.16 kg/m2Her systemic examination was normal except for temporal hemianopia suggesting a sellar/suprasellar lesion. Hormonal evaluation revealed pan-hypopituitarism with central diabetes insipidus. Subsequent neuroimaging revealed sellar-suprasellar mass lesion with intense contrast enhancement and leptomeningeal metastases. Cerebrospinal fluid analysis showed elevated β human chorionic gonadotropin and the presence of syncytiotrophoblast germ cells. Histopathology from the mass lesion confirmed the diagnosis of germinoma. Immunohistochemistry of the tumour tissue was positive for c-kit and placental alkaline phosphatise. She received a combination of chemotherapy with craniospinal irradiation. Significant weight loss in a young woman may not always be an eating disorder like anorexia nervosa albeit more common than germ cell tumour.
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ashu
authors.initials: A
authors.lastname: Rastogi
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Pavan
authors.initials: P
authors.lastname: Uppula
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Chandigarh UT, India.
authors.forename: Kanchan Kumar
authors.initials: KK
authors.lastname: Mukherjee
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.|Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
mesh_terms: D000328:Adult; D000855:Anorexia / Q000209:etiology*; D015992:Body Mass Index; D016543:Central Nervous System Neoplasms / Q000150:complications*; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005260:Female; D018237:Germinoma / Q000150:complications*; D006801:Humans; D055948:Sarcopenia / Q000209:etiology; D015431:Weight Loss
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human