Germinoma of the central nervous system

Case contributed by Dr Ahmed Abd Rabou

Presentation

Headache and visual disturbance. The patient had previous VP shunt placement for obstructive hydrocephalus.

Patient Data

Age: 32 years old
Gender: Male

A well circumscribed lobulated space occupying lesion occupys the pineal region and compressing the tectum anteriorly with obstruction of the acqueduct of sylvius. The mass displays hyperintense signal in non contrast T1 WI, hyperintense signal in T2 and FLAIR images with central area of calcification returns low signal in all pulse sequences (engulfed pineal gland). It also exhibits strong homogenous enhancement after IV contrast. cystic areas are seen within. VP shunt is well placed.

Case Discussion

DD of pineal region tumors includes pineoblastoma, pineocytoma, meningioma and astrocytoma and it was confirmed pathologically to be Germinoma. The engulfed calcified pineal gland favors the diagnosis of germ cell tumor.

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Case information

rID: 24296
Case created: 5th Aug 2013
Last edited: 28th Mar 2016
Inclusion in quiz mode: Included

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