PMC8221666_01
Preoperative sagittal (a) and coronal (b) T1 with contrast MRI demonstrating giant germ cell tumor of the pineal region. Postoperative sagittal (c) and coronal (d) T1 with contrast MRI following gross-total tumor resection.
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The lesion extended superiorly from the roof of the fourth ventricle into the right lateral ventricle, involving the pineal region (Figure 1). Post-operative MRI confirmed a complete resection (Figure 1).
The histopathologic features of the resected mass were that of a tan-gray, semisolid, semicystic glial neoplasm exhibiting mitoses, and vascular proliferation. Mature teratoma with features of the gastrointestinal tract (a) makes up the bulk of the tumor with a minor glial component (b). There are small foci with features of ganglioneuroblastoma (c) which would classify this tumor as an immature teratoma. In a separate focus, there is an area with seminomatous component ((d) area between arrows). Prominent nucleoli are present ((e) small arrows) and these cells are positive for OCT 3/4 on immunohistochemistry (f) (original magnification: a to d are 20x; e and f, and all insets are 60x).
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