Suprasellar germinomas in childhood and adolescence: diagnostic pitfalls

Ramelli, G P; von der Weid, N; Stanga, Z; Mullis, P E; Buergi, U (1998). Suprasellar germinomas in childhood and adolescence: diagnostic pitfalls. Journal of pediatric endocrinology & metabolism, 11(6), pp. 693-7. Berlin: De Gruyter 10.1515/JPEM.1998.11.6.693

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The clinical and neuro-endocrine data of seven young male patients with suprasellar germinomas seen between 1984 and 1992 are reported. The most common initial symptom was 'idiopathic' central diabetes insipidus (DI), which occurred in all seven patients. The time interval between the appearance of this first clinical sign and the definitive diagnosis of a suprasellar germinoma ranged from 3 to 66 months. Raised prolactin levels and growth hormone deficiency were indicators of a process located in the hypothalamic-pituitary region. An increased beta-HCG level in the serum or the CSF confirmed the diagnostic suspicion of a germinoma and was helpful as a tumor marker in follow-up. Neuro-radiologic studies (CT or MRI) were also disappointing in the early stage when patients presented only with DI. Later on, as patients developed additional symptoms or signs related to the tumor, imaging studies were positive. Given the variable rate of tumor progression, the nonspecific early signs of hypothalamic-pituitary dysfunction (DI) as well as the often negative early imaging studies, the diagnosis of suprasellar germinoma is difficult but should always be considered in the presence of so-called 'idiopathic' central DI. Repeated brain MRIs are mandatory in young patients with idiopathic DI in order not to miss an underlying suprasellar germinoma.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Stanga-Nodari, Zeno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0334-018X

Publisher:

De Gruyter

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:24

Last Modified:

01 Oct 2020 09:20

Publisher DOI:

10.1515/JPEM.1998.11.6.693

PubMed ID:

9829222

Web of Science ID:

000076487000003

URI:

https://boris.unibe.ch/id/eprint/37918 (FactScience: 215102)

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