Suprasellar Germinomas: 2 Case Reports and Literature Review

A 13‐Year‐Old Girl with Worsening Visual Function

“…In our case, the tissue consisted of large round cells with clear cytoplasm and round nuclei with prominent vesicular nuclei resembling primordial germ cells. Moreover, immunohistochemistry revealed tumor cells positive for placental alkaline phosphatase, c‐kit, SALL4 and Oct3/4, which are highly expressed in germinomas , supporting the diagnosis of germinomas. Postoperatively, our patient had obvious recovery of visual acuity and subsequently underwent systemic chemotherapy and radiotherapy.…”

“…Suprasellar germinomas initially arise from the hypothalamus, then extend to the infundibulum as they enlarge, mimicking pituitary macroadenoma. The usual presenting symptoms of suprasellar germinoma are hypothalamic‐pituitary dysfunction, visual impairment and diabetes insipidus (DI) . The serum tumor markers, β‐human chorionic gonadotropin and ɑ‐fetoprotein, are informative in only a few patients.…”

Case Report: SARS-CoV-2 Infection in a Child With Suprasellar Tumor and Hypothalamic-Pituitary Failure

“…Primary central nervous system (CNS) germ cell tumors (GCT) are a heterogeneous group of tumors that are still poorly understood. Most of these tumors develop along the midline, mainly from the pineal gland, followed by tumors arising in the suprasellar cistern ( 6 ). The suprasellar region is the second most common location of intracranial germinomas and it has been clear for decades that suprasellar germinomas can cause diabetes insipidus, visual disturbances, and pituitary dysfunctions.…”

“…Treatment protocols for CNS GCTs have evolved greatly and the survival rate for germinomas is more than 90%, whereas NGGCTs have a 10-year overall survival of 60-80% ( 7 ). In most cases, these tumors are associated with permanent endocrine disorders that must be continuously followed up ( 6 ).…”

Pineal Dysgerminoma: A Misleading Clinical Course With Potential Life-Threatening Consequences

“…Pineal tumors usually compress the tectal plate, which can result in obstruction of the Sylvian aqueduct, causing obstructive hydrocephalus [6]. Patients present with signs and symptoms of increased intracranial pressure secondary to mass effect on adjacent structures, such as headache, vomiting, papilledema, lethargy, and somnolence [5,7]. Headaches that awaken the patient in the middle of the night, appear in the morning, and get worse while laying down or with other Valsalva maneuvers, are particularly concerning.…”