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.