Work

Bilateral extramidline involvement in intracranial germinoma: diagnostic lessons from a complex presentation

Year: 2026

Type: article

Abstract: A 25-year-old man presented with subacute progressive anxiety, cognitive deficits, hypernatremia, and left hemiparesis. Magnetic resonance imaging demonstrated multifocal lesions in bilateral basal ganglia (globus pallidus and putamen), fornices, pineal region, along with Wallerian degeneration of the right corticospinal tract with right brainstem atrophy. Serum B-hCG, alpha-fetoprotein, alkaline phosphatase, and placental alkaline phosphatase were normal. Cerebrospinal fluid studies were unremarkable. Brain biopsy revealed intracranial germinoma. The case herein presented highlights a rare presentation of an uncommon neuro-oncological condition that often demonstrates excellent treatment response but is often diagnosed late due to its non-specific presenting symptoms.

Source: Arquivos de Neuro-Psiquiatria

DOI: 10.1055/s-0046-1816037

Authors: Fei He, Renato P. Munhoz, Suneil K. Kalia, Leah M. Skory, David F. Tang-Wai

Institutions: University Health Network, University of Toronto, Toronto Western Hospital, Krembil Brain Institute

Language: English

Topic: Testicular diseases and treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $200