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2021, Number 2

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Arch Neurocien 2021; 26 (2)

Germinoma with diffuse subependymal quadriventricular, cerebellar, and rostral brainstem spread. Case report

Villarreal-García E, Contreras-Guerrero J, Fragoza-Sánchez E, Quiñones-González AM, Díaz-Juárez E, Medina-Romero JR
Full text How to cite this article

Language: Spanish
References: 7
Page: 26-29
PDF size: 522.88 Kb.


Key words:

germinoma, immunohistochemistry, quadriventricular, subependymal, tumor marker.

ABSTRACT

Introduction: germinoma of the central nervous system have a predilection for the midline, the differential diagnosis is broad, immunohistochemistry determines the definitive diagnosis.
Clinical case: a 19-yearold male begins with double vision when staring or following objects, bilateral frontal headache, without radiation, stabbing. Decreased visual acuity was added, with third cranial nerve palsy to conjugated gaze supraversion, absent Babinski, intention tremor, ataxic gait to TANDEM and dizziness when performing it. Upon admission; clinical diagnosis, cerebellar verm syndrome; imaging diagnosis, likely primary brain lymphoma and non-communicating hydrocephalus; surgical management, placement of the right precoronal point, ventriculo-peritoneal shunt valve, and sampling of cerebrospinal fluid; tumor markers, negative; pharmacological management, ceftriaxone and albendazole; incisional biopsy due to left parietal stereotactic surgery, intraoperative biopsy, lymphoid atypia; histopathological diagnosis, neoplastic lesion; immunohistochemical diagnosis, germinoma.
Conclusion: this is the first described case of a midline germinoma with diffuse subependymal quadriventricular, cerebellar and rostral brain stem spread.


REFERENCES

  1. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007; 114(2):97–109. Doi:10.1007/s00401-007-0243-4

  2. Lieuw KH, Haas-Kogan D, Ablin A. Intracranial germ cell tumors. in: Gupta N., Banerjee A., Haas-Kogan D. (eds) Pediatric CNS tumors. Pediatric Oncology. Springer, Berlin, Heidelberg.2004. Doi: https://doi.org/10.1007/978-3-662-09227-9_7

  3. Krueger EM, Invergo DL, Lin JJ. Germinoma with diffuse subependymal spread: acase report. Cureus. 2016; 8(6):e643. DOI: 10.7759/cureus.643

  4. Suresh TN, Mahadevan A, Santosh V, Shankar SK. Subarachnoid spread of germinoma mimicking tuberculous meningitis.Neurology India. 2004; 52(2):251-253. https://www.neurologyindia.com/ text.asp?2004/52/2/251/11057

  5. Yang C, Jagjivan B, Rao K. Germinoma-unusual presentation: a case report. Conn Med. 2004; 68(10):617–19. PMID: 15626137.

  6. Félix IA. Atlas de neuropatología. Editorial Auroch, México. 2000: 41-51.

  7. David N. Louis, Hiroko Ohgaki, Otmar D. Wiestler,Webster K. Cavenee (Eds):WHO Classification of tumours of the central nervous system (revised 4th edition).IARC; Lyon 2016.




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Arch Neurocien. 2021;26