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Joseph Junewick, MD FACR
over 7 years ago
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Suprasellar Germinoma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 7 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

13 year old female with chronic diabetes insipidus.


Case Images


Diagnosis

Suprasellar Germinoma

Findings

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

Discussion

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.

Reference

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



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