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Unusual behaviour of a pineal germinoma mimicking neurosarcoidosis and metastasising along the endoscopic route
- Publication Year :
- 2013
- Publisher :
- BMJ Publishing Group, 2013.
-
Abstract
- A previously healthy man underwent endoscopic biopsy for a suspected pineal germinoma. Histology and immunohistochemistry did not confirm the preoperative diagnosis, and neurosarcoidosis was hypothesised because of the presence of granulomatous reaction. The patient remained in good health for 3 years and was still asymptomatic when a control MRI showed metastasis implantation along the endoscopic route. A redobiopsy provided the diagnosis of germinoma, but was complicated by severe ventricular haemorrhage requiring emergency clot excision. Postoperative clinical conditions were so severe that the treatment of germinoma was postponed. Three months later, repeated MRI showed tumour progression. Chemotherapy promoted good tumour regression so that the treatment was completed by radiation therapy. The tumour completely disappeared on MRI, but the patient remained severely disabled because of the haemorrhage.
- Subjects :
- Adult
Male
medicine.medical_specialty
Sarcoidosis
medicine.medical_treatment
Asymptomatic
Pineal Gland
Article
Diagnosis, Differential
Neoplasm Seeding
Central Nervous System Diseases
medicine
Humans
Germinoma
business.industry
Brain Neoplasms
Neurooncology
Neurosarcoidosis
Endoscopy
General Medicine
medicine.disease
Surgery
Hydrocephalus
Radiation therapy
Neurosurgery
Radiology
Differential diagnosis
medicine.symptom
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....97501c3335f3ddc55580120264741401