Thalamic Germinoma in a Child with Symptoms of Precocious Pseudopuberty –  a Case Report

Authors: Z. Pavelka 1;  O. Magnová 2;  L. Křen 3;  T. Svoboda 4;  E. Brichtová 5;  J. Štěrba 1
Authors‘ workplace: LF MU Brno a FN Brno Klinika dětské onkologie 1;  LF MU Brno a FN Brno Pediatrická klinika 2;  LF MU Brno a FN Brno Ústav patologie 3;  LF MU Brno a FN Brno Neurochirurgická klinika 4;  LF MU Brno a FN Brno Neurochirurgické oddělení Kliniky dětské chirurgie, ortopedie a traumatologie 5
Published in: Cesk Slov Neurol N 2013; 76/109(4): 497-500
Category: Case Report


We describe a case of a 6 years old boy with germinoma of an unusual thalamic localization that presented with precocious pseudopuberty based on ectopic human chorionic gonadotropin (hCG) secretion. The tumour was confirmed with stereotactic biopsy; subsequent chemotherapy and radiotherapy led to complete remission. The mechanism of precocious pseudopuberty and clinical and treatment aspects of brain germinomas in children arediscussed.

Key words:
germinoma – central nervous system – human chorionic gonadotropin – pseudopuberty – chemotherapy – radiotherapy


1. Kleihues P, Cavanee WK. Pathology and genetics of tumors of the nervous system. Lyon: International Agency for Research on Cancer (IARC) Press 2007.

2. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007; 114(2): 97– 109.

3. Pizzo PA, Poplack DG. Principles and Practice of Pediatric Oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins 2005.

4. Childrens Oncology Group [online]. Available from: members/ protocols/ CNS.

5. González- Sánchez V, Moreno‑Pérez O, Pellicer PS, Sánchez- Ortiga R, Guerra RA, Dot MM et al. Validation of the human chorionic gonadotropin immunoassay in cerebrospinal fluid for the diagnostic work- up of neurohypophyseal germinomas. Ann Clin Biochem 2011; 48(5): 433– 437.

6. Phi JH, Cho BK, Kim SK, Paeng JC, Kim IO, Kim IH et al. Germinomas in the basal ganglia: magnetic resonance imaging classification and the prognosis. J Neurooncol 2010; 99(2): 227– 236.

7. Jorsal T, Rørth M. Intracranial germ cell tumours. A review with special reference to endocrine manifestations. Acta Oncol 2012; 51(1): 3– 9.

8. Tamaki N, Lin T, Shirataki K, Hosoda K, Kurata H, Matsumoto S et al. Germ cell tumors of the thalamus and the basal ganglia. Childs Nerv Syst 1990; 6(1): 3– 7.

9. Ng WK, Lam KY, Ng IO. Langerhans‘ cell histiocytosis: possible association with malignant germ cell tumour. J Clin Pathol 1995; 48(10): 963– 965.

10. Stephen MD, Zage PE, Waguespack SG. Gonadotropin‑dependent precocious puberty: neoplastic causes and endocrine considerations. Int J Pediatr Endocrinol 2011; 2011: 184502.

11. Fadrus P, Lakomý R, Hübnerová P, Slabý O, Keřkovský M, Svoboda T et al. Intrakraniální nádory –  diagnostika a terapie. Intern Med Prax 2010; 12(7,8): 376– 381.

Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 4

2013 Issue 4

Most read in this issue
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account