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A difficult case
Intracranial germinoma causing cerebral haemiatrophy and hypopituitarism
  1. Bruno Fukelmann Guedes1,
  2. Marcio Nattan Portes Souza1,
  3. Breno José Alencar Pires Barbosa1,
  4. Fernando Pereira Frassetto2,
  5. Leandro Tavares Lucato3,
  6. Carla Rachel Ono3,
  7. Luiz Henrique Martins Castro1,
  8. Ricardo Nitrini1,
  9. Mateus Mistieri Simabukuro1
  1. 1Neurology Department, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
  2. 2Pathology Department, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
  3. 3Radiology Institute, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
  1. Correspondence to Dr Bruno Fukelmann Guedes, Neurology Division, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil; bruno.guedes{at}hc.fm.usp.br

Abstract

A young woman presented with primary amenorrhoea, progressive haemiparesis, visual disturbance, dementia and focal motor seizures. Investigations showed hypopituitarism, unilateral cerebral atrophy and inflamed cerebrospinal fluid. A trans-sphenoidal biopsy gave a unifying diagnosis of a pituitary germinoma.

  • tumours
  • paediatric neurology
  • paediatric neuropathology
  • neuroimmunology
  • neuroendocrinology

https://doi.org/10.1136/practneurol-2017-001771

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    Footnotes

    • BF and MN contributed equally.

    • Contributors BFG, MNPS: background research. BJAPB, MNPS: clinical data collection. FPF: pathological specimen analysis and manuscript draft. LTL: revision of CT/MRI findings for the case report and manuscript revision. CRO: revision of nuclear imaging findings for the case report and manuscript revision. LHMC, MNPS, BJAPB, MMS: participated in patient care. RN, BFG, MNPS, BJAPB, LHMC: manuscript draft/revision. MMS: conceptualised and revised the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Jeremy Rees, London, UK.