PMC3815051_01
Contrasted CT of tumor in corpus callosum with intraventricular involvement
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F1
Thickening and enhancement was also noted along the margins of both lateral ventricles and a 1.3x0.9 cm enhancing nodule visualised in the 4th ventricle [Figure 1].
Noncontrasted MRI of tumor in corpus callosum with intraventricular involvement
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F2
Subsequent magnetic resonance imaging (MRI) brain reported multiple intraventricular contiguous and noncontiguous cystic masses with extension superiorly into the frontal horns, the genu of the corpus callosum and the septum pellucidum, inferiorly into the suprasellar region, as well as laterally into the right temporal horn [Figure 2].
Photomicrograph of germinoma (H and E, x200) featuring sheets of large primitive cells with round nuclei bearing prominent nucleoli, and ample clear cytoplasm with discrete cell membranes, interrupted by fibrous septa containing smaller reactive lymphocytes
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F3
Histology revealed a germinoma composed of sheets of large primitive cells with round nuclei bearing prominent nucleoli, and ample clear cytoplasm with discrete cell membranes, interrupted by fibrous septa containing smaller reactive lymphocytes [Figure 3].
Contrasted MRI 1 month after completion of treatment
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F4
Radiologically, his lesions remained stable despite completing treatment [Figure 4] but he demonstrated good biochemical response with CSF b-HCG falling from 1837.01 IU/L to less than 2.0 IU/L.