Endocrine Abstracts

Introduction

Germ cell tumour are embryonic tumour localized mainly at the gonads level, their cerebral localization is rare with less than 1% of intracranial neoplasia.

Observation

We have reported a 20 years old girl case without pathological history who had progressive diabetes insipidus for one year associated with spaniomenorrhea, the MRI revealed an aspect suggesting a pineal stem germinoma (12 mm of major axis), with a second localization at the pituitary stalk (12 mm of major axis) and a disappearance of the spontaneous hyper signal of the post-pituitary gland, measurement of tumour markers: was positive for the B HCG at 8.33 u UI/ml (normally < 2 m UI/ml) and normal for the other markers, which confirmed the diagnosis of pure germinoma without biopsy.

Discussion

Germinomas of suprasellar and pineal dual localization remain rare and present only 5–10% of germinomas with only 15 cases reported in the literature, the clinical expression is polymorphic and imaging provides a highly evocative radiological semiology, the treatment is mainly based on radiotherapy and sometimes on a combination of radio and chemotherapy this last alternative was our therapeutic choice with a good clinical and biological evolution.