Intracranial Pure Germinoma With Optic Nerve Infiltration

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Title Intracranial Pure Germinoma With Optic Nerve Infiltration
Creator Devon A. Cohen, M. Tariq Bhatti, Caterina Giannini, Laurence J. Eckel, James A. Garrity, John J. Chen
Affiliation Departments of Neurology (DAC, MTB, JJC), Ophthalmology (MTB, JAG, JJC), Laboratory Medicine and Pathology (CG), Radiology (LJE), Mayo Clinic College of Medicine, Rochester, Minnesota
Abstract A 19-year-old man presented with a 3-year history of episodic headaches, right hemiparesis, and progressive vision loss in both eyes. Initially, extensive laboratory testing was unrevealing. MRI later demonstrated progressive enlargement and enhancement of the left optic nerve poorly correlated with the timing of his clinical manifestations. There was no clinical or radiological response to treatment with corticosteroids, mycophenolate mofetil, or rituximab administered empirically for possible inflammatory processes. Later in the disease course, he developed diabetes insipidus (DI), worsening vision to light perception bilaterally, severe cognitive decline, and spastic quadriparesis. Cerebrospinal fluid (CSF) beta human chorionic gonadotropin (β-hCG) was elevated. Eventually, a left optic nerve biopsy was performed, which was consistent with an intracranial pure germinoma with infiltration of the optic nerve and disseminated leptomeningeal disease. Although rare, intracranial germ cell tumors can primarily involve the anterior visual pathways and should be considered in the setting of DI and elevated CSF β-hCG.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2020-03
Type Text
Source Journal of Neuro-Ophthalmology, March 2020, Volume 40, Issue 1
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s61p3sh3
Setname ehsl_novel_jno
Date Created 2021-01-22
Date Modified 2021-05-06
ID 1653464
Reference URL
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