Giant intracranial germinoma
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LETTER TO THE EDITOR
Giant intracranial germinoma Joaquin Hidalgo1 · Alan R. Cohen1 Received: 23 May 2020 / Accepted: 23 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
To the editor, An 8-year-old girl was referred to the neurosurgery clinic with headache, excessive thirst and urination and progressive visual loss over 6 months. Physical examination showed no light perception O.D. and visual acuity 20/200 with a temporal hemianopia O.S., with bilateral optic atrophy. Cranial MRI demonstrated a large, midline, multilobular, heterogeneously enhancing, diffusion-restricting sellar/ suprasellar mass invading the sphenoid sinus, infiltrating the cavernous sinuses, encasing the carotid arteries and optic apparatus and extending into the third ventricle, along with a small enhancing pineal region mass [Panels A, B]. MRI of the spine was unremarkable. Laboratory investigation showed a serum beta human chorionic gonadotropin level of 3.6 m [IU]/mL (reference 0–1.0) and an alpha fetoprotein level of 1.4 ng/mL (reference 0–10). CSF was obtained via lumbar puncture. CSF β-HCG was 21.5 m [IU]/ml and αFP was
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