case_images: PMC10978038_01
case_images: Axial (a), coronal (b), and sagittal (c) postcontrast T1-weighted images revealed contrast-enhanced lesions spanning from the septum pellucidum to the right frontal lobe (white arrow) and from the pons to the dorsal medulla oblongata (arrowhead). The tumor contained multiple cysts on T2-weighted images (d, red arrow), and fluid attenuation inversion recovery images revealed peritumoral edema (e, blue arrow). Diffusion-weighted images revealed diffusion restriction of the tumor parenchyma (f, yellow arrow). Postcontrast T1-weighted images at 18 months after surgery revealed complete tumor resolution with no evidence of recurrence (g, h).
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case_images: PMC10978038_01_cro-2024-0017-0001-538088_F01.jpg
case_images: F1
case_images: Head MRI revealed neoplastic lesions in two areas, with one lesion spanning from the septum pellucidum to the right anterior horn and the other spanning from the pons to the dorsal medulla oblongata, as well as cystic changes in some areas and hydrocephalus (Fig. 1).
case_images: Hematoxylin and eosin staining revealed a two-cell pattern of large tumor cells with a distinct nucleolus and the infiltration of small lymphocytes (a). Immunohistochemical staining illustrated that tumor cells were positive for SALL (b) and D2-40 (c).
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case_images: PMC10978038_01_cro-2024-0017-0001-538088_F02.jpg
case_images: F2
case_images: The lesions were immunohistochemically positive for c-kit, D2-40, and SALLA4, and a pathological diagnosis of germinoma was made (Fig. 2).
case_images: Timeline chart of preoperative and postoperative progress. WBRT, whole-brain radiotherapy.
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case_images: PMC10978038_01_cro-2024-0017-0001-538088_F03.jpg
case_images: F3
case_images: We have compiled a timeline chart of the patient's progress before and after surgery, which is shown in Figure 3.