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Joseph Junewick, MD FACR
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Suprasellar Germinoma

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 10 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: MR
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13 year old female with chronic diabetes insipidus.

Case Images


Suprasellar Germinoma


MR – Solid and cystic enhancing suprasellar mass with hypothalamic compression.


Germinomas are tumors arising from germ cells. Although these lesions are most commonly located in the pineal region, they can also occur in the hypothalamic region. Synchronous lesions in the hypothalamic and pineal regions account for 10% of all intracranial germ cell tumors. Hypothalamic germinomas affect males and females with equal frequency and commonly cause diabetes insipitus, emaciation, or precocious puberty. At MR imaging, germinomas are iso-to hypointense on T1-weighted sequences and iso- to slightly hyperintense on T2-weighted sequences. Contrast enhancement is intense and homogeneous. Suprasellar germinomas usually lack cystic and calcific components. The high signal intensity of the posterior pituitary lobe may not be seen on sagittal T1-weighted images due to blockage of the infundibulum by the mass. It is important to remember that occasionally the germinoma may not be visible on imaging even when a hypothalamic symptoms are present.


Saleem SN, Said AM, Lee DH. Lesions of the Hypothalamus: MR Imaging Diagnostic Features. Radiographics (2007); 27:1087-1108.

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