A Case Report of Primary Cerebellar Germinoma and Literature Review

Abstract

Intracranial germ cell tumors occurred mostly in midline structures such as pineal or suprasellar regions. Unilateral lesions as in basal ganglia and thalamus have also been reported, whereas germ cell tumors originating in the posterior fossa are very rate; those in the cerebellar hemisphere are even rarer. Described herein is a case of primary germinoma found in the right cerebellar hemisphere which is rarely reported in the literature. A 17 y/o male patient had suffered from progressive headache and unsteady gait for 6 months. MRI study of head revealed a nonspecific right cerebellar focal lesion with moderate enchancement after contrast medium injection. Glioma, post-infection or other diagnosis was impressed. Suboccipital craniectomy with total tumor excision was performed. During operation the tumor was noted to located in right cerebellar hemisphere and be pink and soft measuring about 1 cm in diameter. Histologic examination of the surgical specimen revealed a typical picture of germinoma. Since primary cerebellar germinoa has rarely been reported, metastasis of the tumor from testicular seminoma or seeding from pineal, or suprasellar germnoma is the most probable diagnosis. However, extensive examination indicated the tumor to be primary in origin. The tumor was successfully treated by surgery and post-operative radiotherapy. (Tzu Chi Med J 1996; 8: 323-327)