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Child's Nervous System

, Volume 35, Issue 9, pp 1615–1619 | Cite as

Primary cavernous sinus germinoma with atypical extension pattern: a case report and review of the literature

  • Kazuki SakakuraEmail author
  • Takao Tsurubuchi
  • Tomohiko Masumoto
  • Ai Muroi
  • Eiichi Ishikawa
  • Akira Matsumura
Case Report
  • 80 Downloads

Abstract

Primary intracranial germinoma is a rare central nervous system tumor that usually arises in the pineal and the supra-sellar region. Here, we report a rare case of primary intracavernous sinus germinoma with an atypical extension pattern, with a comparison to germinomas originating from the cavernous sinus as described in the existing literature. A 12-year-old boy was admitted to our hospital with the chief complaint of the left-side ptosis and double vision. Magnetic resonance imaging showed homogenous enhanced mass lesion in the pineal region together with mass lesions in the lateral ventricle, left cavernous sinus, and temporal lobe, extending into the left masticator space. The enhanced mass in the intracavernous sinus originated from the cavernous sinus. Endoscopic third ventriculostomy and tumor biopsy was done. Pathological diagnosis was pure germinoma. After six courses of chemotherapy followed by radiation therapy, all the lesions decreased in size significantly. Only faint enhancement around the masticator space remained. We report a rare case of a germinoma that developed mainly in the cavernous sinus with additional tumor masses in the pineal region, ventricles, and temporal lobe. Although the lesions shrank significantly on the post-chemoradiation imaging, a long follow-up is necessary not only to check for symptoms, but also monitor imaging findings for possible serial changes in the residual region of the masticator space.

Keywords

Germinoma Cavernous sinus Radiotherapy Chemotherapy 

Abbreviations

AFP

Alpha fetoprotein

ETV

Endoscopic third ventriculostomy

HCG-β

Beta human chorionic gonadotropin

MRI

Magnetic resonance imaging

Notes

Acknowledgements

The authors would like to thank Alexander Zaboronok and Thomas Mayers of the University of Tsukuba Medical English Communications Center for the proofreading of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from the next of kin.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Kazuki Sakakura
    • 1
    Email author
  • Takao Tsurubuchi
    • 1
  • Tomohiko Masumoto
    • 2
  • Ai Muroi
    • 1
  • Eiichi Ishikawa
    • 1
  • Akira Matsumura
    • 1
  1. 1.Department of Neurosurgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
  2. 2.Department of Radiology, Faculty of MedicineUniversity of TsukubaTsukubaJapan

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