OBJECTIVE: To report a case series in which basal ganglia calcifications without mass effect proved to be germ cell tumors. DESIGN: Case series. SETTING: Tertiary care hospital. PATIENTS: Four patients. INTERVENTIONS: Computed tomography, magnetic resonance imaging, positron emission tomography, biopsy, chemotherapy, and radiation therapy. MAIN OUTCOME MEASURES: Recognition of clinical syndrome and radiological features. RESULTS: All patients had progressive hemiparesis, and 1 patient also had frontal lobe dementia. Imaging demonstrated progressive asymmetric signal abnormality with basal ganglia calcification and associated brainstem atrophy. Fludeoxyglucose F 18-positron emission tomography showed hypometabolism in contrast to malignant glioma. CONCLUSION: Germ cell tumor should be considered in patients with an indolently progressive neurological course, particularly if basal ganglia calcification is present with or without enhancement, asymmetric brain atrophy, or a mass.
OBJECTIVE: To report a case series in which basal ganglia calcifications without mass effect proved to be germ cell tumors. DESIGN: Case series. SETTING: Tertiary care hospital. PATIENTS: Four patients. INTERVENTIONS: Computed tomography, magnetic resonance imaging, positron emission tomography, biopsy, chemotherapy, and radiation therapy. MAIN OUTCOME MEASURES: Recognition of clinical syndrome and radiological features. RESULTS: All patients had progressive hemiparesis, and 1 patient also had frontal lobe dementia. Imaging demonstrated progressive asymmetric signal abnormality with basal ganglia calcification and associated brainstem atrophy. Fludeoxyglucose F 18-positron emission tomography showed hypometabolism in contrast to malignant glioma. CONCLUSION: Germ cell tumor should be considered in patients with an indolently progressive neurological course, particularly if basal ganglia calcification is present with or without enhancement, asymmetric brain atrophy, or a mass.