Journal of Neuro-Oncology

, Volume 79, Issue 3, pp 255–258 | Cite as

Primary midbrain cystic germinoma mimicking glioma: a case with neuroendoscopic biopsy

  • Masafumi Uchino
  • Daisuke Haga
  • Toshiaki Mito
  • Tohru Kuramitsu
  • Noriko Nakamura
Laboratory investigation


Intracranial germinoma arising primarily in the midbrain is extremely rare. We present the first reported case of cystic midbrain germinoma that lacked evident solid components and mimicked a midbrain glioma. In a 22-year-old man with headache and diplopia, magnetic resonance imaging showed a ring-enhancing lesion in the midbrain. The preoperative diagnosis included brain stem glioma, metastasis, and neuroepithelial cyst. A neuroendoscopic biopsy specimen provided a histologic diagnosis of germinoma. The patient responded well to chemotherapy and radiotherapy. The case illustrates the diagnostic value of neuroendoscopic biopsy in the differential diagnosis of brainstem lesions in adult. The possibilities considered should now include germinoma.


cyst germinoma glioma midbrain neuroendoscopy 


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  1. 1.
    Amor SB, Siddiqui K, Baessa S: Primary midbrain germinoma Br J Neurosurg 18: 310–313, 2004CrossRefPubMedGoogle Scholar
  2. 2.
    Matsumoto K, Tabuchi A, Tamesa N, Nakashima H, Ohmoto T: Primary intracranial germinoma involving the midbrain Clini Neurol Neurosurg 100:292–295, 1998CrossRefGoogle Scholar
  3. 3.
    Uchino M, Nemoto M, Ohtsuka T, Seiki Y, Shibata I: Extraneural metastasis of pineal germinoma through a Ventriculoperitoneal Shunt Following histological change: No Shinkei Geka 27:269–274, 1999 [Article in Japanese with English abstract]PubMedGoogle Scholar
  4. 4.
    Higano S, Takahashi S, Ishi K, Matsumoto K, Ikeda H, Sakamoto K Germinoma originating in the basal ganglia and thalamus: MR and CT evaluation AJNR 15:1435–1441, 1994PubMedGoogle Scholar
  5. 5.
    Kim DI, Yoon PH, Ryu YH, Jeon P, Hwang GJ MRI of germinomas arising from the basal ganglia and thalamus Neuroradiology 40:507–511, 1998CrossRefPubMedGoogle Scholar
  6. 6.
    Moon WK, Chang KH, Kim IO, Han MH, Choi CG, Suh DC, Yoo SJ, Han MC Germinomas of the basal ganglia and thalamus: MR findings and a comparison between MR, CT AJR 162:1413–1417, 1994PubMedGoogle Scholar
  7. 7.
    Soejima T, Takeshita I, Yamamoto H, Tsukamoto Y, Fukui M, Matsuoka S Computed tomography of germinoma in basal ganglia and thalamus Neuroradiology 29:366–370, 1987CrossRefPubMedGoogle Scholar
  8. 8.
    Sun B, Wang CC, Wang J: MRI characteristics of midbrain tumours Neuroradiology 41:158–162, 1999CrossRefPubMedGoogle Scholar
  9. 9.
    Mizoguchi M, Inamura T, Hikita T, Cheng CL, Ohgami S Neuroendoscopic biopsy of tectal glioma: case report Minim Invas Neurosurg 43:53–55, 2000CrossRefGoogle Scholar
  10. 10.
    Nishikawa T, Kang Y, Lee T, Takehira N, Waga S: Application of endoscopy for a midbrain tumor Minim Invas Neurosurg 46:182–185, 2003CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Masafumi Uchino
    • 1
  • Daisuke Haga
    • 1
  • Toshiaki Mito
    • 1
  • Tohru Kuramitsu
    • 1
  • Noriko Nakamura
    • 2
  1. 1.Department of NeurosurgerySaiseikai Yokohama-shi Nambu HospitalKanagawa-kenJapan
  2. 2.Department of PathologySaiseikai Yokohama-shi Nambu Hospital,YokohamaJapan

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