J Korean Soc Radiol.  2011 Jan;64(1):11-15. 10.3348/jksr.2011.64.1.11.

Rapidly Progressing Germinoma Arising in the Lateral Ventricle and This Mimicked Choroid Plexitis

• Pang JC
• Byun JS
• Kim JK
• Ha SY
• Park KY
• Hwang SN
• Kim M

• KMID: 1443576
• DOI: http://doi.org/10.3348/jksr.2011.64.1.11

Abstract

There are no previous reports of germinoma primary arising in the lateral ventricle. We describe here a case of a 50-year-old man with lateral ventricular germinoma that showed rapid progression, and this tumor mimicked choroid plexitis.

MeSH Terms

Choroid
Choroid Plexus
Germinoma
Humans
Lateral Ventricles
Middle Aged

Figure

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  Fig. 1 The axial postcontrast T1-weighted MR image (A and B) demonstrated the enlarged choroid plexus (arrow in figure A) and the adjacent ependymal enhancement in the trigone of the right lateral ventricle (arrows in figure B), and there is suspicious ependymal enhancement and a mildly enlarged choroid plexus in the left lateral ventricle. The axial FLAIR MR image (C) showed high signal intensities in the septum pellucidum (arrow in figure C) and along the trigone of the right lateral ventricle. The sagittal postcontrast T1-weighted MR image (D) demonstrated a suspicious mildly enlarged choroid plexus in the fourth ventricle, and no abnormal lesion in the pineal or suprasellar regions.

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  Fig. 2 The axial postcontrast T1-weighted MR images (A and B) demonstrate more progression of the dense enhancement of the enlarged choroid plexus (arrow in figure A) and adjacent ependymal enhancement in the right lateral ventricle and obvious dense enhancement of the enlarged choroid plexus (arrowhead in figure A) and ependymal enhancement (arrow in figure B) in the left ventricle. There are newly enhancing lesions in the ependyma of the right lateral ventricle. The axial FLAIR MR image (C) showed progression of the high signal intensities around both the lateral ventricles, and especially along the right lateral ventricle. The sagittal postcontrast T1-weighted MR image (D) depicts definite dense enhancement of the enlarged choroid plexus in the fourth ventricle (double arrows in figure D) and newly enhancing lesions have appeared in the pineal region (arrow in figure D) and the anterior wall of the fourth ventricle (arrowhead in figure D).

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  Fig. 3 Axial FLAIR MRI showed extensive white matter edema around both lateral ventricles, and especially along the right lateral ventricle, and there is midline shifting to the left.

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  Fig. 4 The hematoxylin and eosin stained section shows primitive germ cells with an infiltration of small lymphoid cells (200 ×). Giant cells are noted among the tumor cells (arrows, the figure at the right lower portion [400 ×]).

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