Metachronous neurohypophyseal germinoma occurring 8 years after total resection of pineal mature teratoma

BACKGROUND Metachronous germ cell tumor in the central nervous system is extremely rare. To our knowledge, only one patient presenting conceivable metachronous intracranial germ cell tumor has been reported. CASE REPORT A neurohypophyseal germinoma occurring 8 years after total resection of a pineal mature teratoma is presented. The patient underwent total resection of a large pineal mass in 1987. Histologic investigation revealed a mature teratoma without any immature or germinomatous components. In 1995, he developed diabetes insipidus. Magnetic resonance imaging depicted an intrasellar mass extending to the floor of the third ventricle. A transsphenoidal biopsy revealed histologically pure germinoma. CONCLUSION The second neurohypophyseal germinoma was considered to be a de novo metachronous neoplasm rather than a recurrence of the original mature teratoma. (C) 1998 by Elsevier Science Inc.