We present a very rare case of suprasellar
germinoma that spontaneously regressed before endoscopic biopsy. An 8-year-old boy was admitted to our hospital due to
headache,
polydipsia, and
polyuria. Neurological examination performed on admission revealed
bitemporal hemianopia. Enhanced MRI demonstrated a homogeneously enhanced
tumor mass in the suprasellar region obstructing the foramen of Monro. Tests for all serum
tumor markers were negative. Plain X-ray and CT scan were performed once and twice, respectively, for seven days between admission and endoscopic biopsy. The total dose of diagnostic radiation exposure before surgery was 110 mGy. Endoscopic observation during surgery revealed that the
tumor had markedly decreased in size and the foramen of Monro had reopened. A very small piece of the
tumor was harvested during surgery. Plain CT scan just after surgery showed a marked decrease in the
tumor size, compared with the preoperative CT scan. The pathological diagnosis of the
tumor was pure
germinoma. The patient then underwent
chemotherapy(four courses of CARE regimen)followed by
radiation therapy with a dose of 24 Gy/15 fr. The
tumor completely disappeared
after treatment, and no recurrence was observed in the past four years.