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Primary intrasellar germinoma^*

Hamilton General Hospital and McMaster University Medical Centre, Hamilton, Ontario, Canada

This excerpt was created in the absence of an abstract.

The purpose of this communication is to report a primary intrasellar germinoma, causing expansion of the pituitary fossa and outlined by air in the suprasellar cistern.

The term suprasellar germinoma is now generally used in preference to ectopic pinealoma, atypical teratoma or a teratoid, to describe a rare malignant tumour which is histologically identical to testicular seminoma and ovarian dysgerminoma. Various authors seem to agree that the tumour probably arises from ectopic germ cells that have been misplaced during their migration from the yolk sac to the gonads in embryogenesis (Simson et al., 1968). These tumours occur more frequently in males, 10 to 30 years of age and reach a peak incidence in the later half of the second decade (Rubinstein, 1972). The majority of intracranial germinomas arise in the pineal region and only few may be found above the pituitary gland. These have been classified according to their relation to the hypothalamus into three types (Kageyama and Belsky, 1961). In the first type, the hypothalamic lesion occurs in association with a similar tumour in the pineal region. In the second and third types, there is a single lesion arising in the floor of the third ventricle or beneath the cerebral hemispheres in the region of the optic chiasm. In the later stages of the disease, these two types cannot be differentiated and extension into the hypophyseal fossa may occur. Under these circumstances, the suprasellar cistern is invariably obliterated. To our knowledge no case has yet been reported where the tumour was shown at pneumoencephalography to arise primarily within the pituitary fossa.

^* Requests for reprints to Dr. M. J. Malot.

Received for publication May 1, 1976.