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20-12-2022 | Magnetic Resonance Imaging | Case Report

Multiple ectopic germinomas presenting as focal dystonia of fingers: a case report and literature review

Authors: Seungju Han, Hwa Jin Cho, Bo Lyun Lee, Keun Soo Lee

Published in: Child's Nervous System | Issue 2/2023

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Abstract

Background

Intracranial primary germinomas predominantly develop on or near the midline structure in children and young adults and are diagnosed by brain imaging and biopsy. However, if brain imaging and pathology show unusual findings, it becomes difficult to make an accurate diagnosis.

Case report

Herein, we report the case of a 14-year-old boy who presented with focal dystonia of the fingers as an initial symptom. Magnetic resonance imaging of the brain showed multifocal heterogeneous lesions with solid and cystic components involving the right frontal lobe, corpus callosum, left basal ganglia, and left corona radiata. A stereotactic biopsy of the right frontal lesion revealed several granulomatous areas with abundant inflammatory cells. After immunohistochemical staining, the patient was diagnosed with germinoma and treated with chemoradiotherapy according to the Korean Society for Pediatric Neuro-Oncology protocol. The patient has been in complete remission for five years.

Conclusion

Germinomas can develop in intracranial off-midline structures, with unusual clinical, radiological, and pathological presentations. It is important to include intracranial germinomas in the differential diagnosis of infiltrative parenchymal tumors, especially in children.
Literature
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go back to reference Pierzchlewicz K, Bilska M, Jurkiewicz E, Chmielewski D, Moszczyńska E, Daszkiewicz P, Ciołkowski M, Grajkowska W, Kotulska K (2019) Germinoma mimicking brain inflammation: a case report. Child Neurol Open 6:2329048X19848181. https://doi.org/10.1177/2329048X1984818 Pierzchlewicz K, Bilska M, Jurkiewicz E, Chmielewski D, Moszczyńska E, Daszkiewicz P, Ciołkowski M, Grajkowska W, Kotulska K (2019) Germinoma mimicking brain inflammation: a case report. Child Neurol Open 6:2329048X19848181. https://​doi.​org/​10.​1177/​2329048X1984818
Metadata
Title
Multiple ectopic germinomas presenting as focal dystonia of fingers: a case report and literature review
Authors
Seungju Han
Hwa Jin Cho
Bo Lyun Lee
Keun Soo Lee
Publication date
20-12-2022
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 2/2023
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-022-05794-z

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