Primary intracranial germ cell tumour originating from right brachium Pontis with hypertrophic Olivary degeneration: a case report

BMC Neurology

Jiayi Wang¹  Jin Feng¹  Jing Zhang¹  Yanong Li¹  Peng Wang¹  Xiaoguang Qiu² 

[1] Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, 119, South 4th Ring West Road, Fengtai District, Beijing, China;Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, 119, South 4th Ring West Road, Fengtai District, Beijing, China;Department of Molecular Neuropathology, Beijing Neurosurgery Institute, Capital Medical University, Beijing, China;

关键词: Germinoma;    Hypertrophic olivary degeneration;    Brachium pontis;    Chemoradiation therapy;   

DOI  :  10.1186/s12883-021-02238-0

来源: Springer

【 摘 要 】

BackgroundPrimary right brachium pontis germinoma with hypertrophic olivary degeneration (HOD) is extremely rare. A preoperative diagnosis is challenging due to the absence of characterized clinical and neuroimaging features, and biopsy should be considered.Case presentationA 20-year-old male patient presented with a case of primary intracranial germinoma originating from right brachium pontis with HOD manifesting as ocular myoclonus, nystagmus in both eyes, ataxic gait and incoordination of the limbs. Magnetic resonance imaging (MRI) revealed an irregular patchy lesion with hyperintensity on T2-weighted images (T2WI) and T2 fluid-attenuated inversion recovery (FLAIR) without enhancement by gadolinium (Gd). Furthermore, a focal hyperintense nodule on T2WI in the left inferior olive nucleus (ION) of the medulla oblongata was considered hypertrophic olivary degeneration (HOD) based on the patient’s symptoms and neuroimaging findings. Due to suspected demyelinating disease and low-grade glioma (LGG), a biopsy was planned. The pathological diagnosis was germinoma. Subsequently, he received chemoradiation therapy, resulting in the improvement of neurological deficits and the disappearance of the lesion on MRI.ConclusionA case of “Primary right brachium pontis germinoma with HOD” is reported for the first time. A preoperative diagnosis is challenging due to the fact of absence of clinical signs and symptoms and neuroimaging characteristics. However, patients can have favourable prognoses with appropriate evaluation and treatment.

【 授权许可】

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