Abstract
AB065. Basal ganglia germ cell tumor presenting with visual loss in adult: a case report
Vega Pangaribuan1, Tedy Apriawan1, Muhammad Azzam2
1Division of Neuro-Oncology, Department of Neurosurgery, Universitas Airlangga Faculty of Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia;
2Airlangga University Hospital, Surabaya, Indonesia
Correspondence to: Vega Pangaribuan, MD. Division of Neuro-Oncology, Department of Neurosurgery, Universitas Airlangga Faculty of Medicine, Dr. Soetomo General Academic Hospital, Prof. Dr. Moestopo Street 47, Surabaya 60132, East Java, Indonesia. Email: vegasolagracia@gmail.com.
Background: Basal ganglia germ cell tumor (GCT) in an adult male is quite rare. Intracranial germ cells tumor usually occurs in the midline axis, involving pituitary, sellar region, or both. Only in rare circumstances GCTs developed in basal ganglia.
Case Description: In this case report, we presented a patient with a main complaint of progressive visual loss from his right eye from one year prior. He had been going to the ophthalmologist but there was no improvement. A brain magnetic resonance imaging (MRI) revealed a large left basal ganglia tumor with involvement of the hypothalamus and uncus, causing pressure on the optic and oculomotor nerve. Interestingly, the patient had no decrease in motor function. Complaints of severe headache, persistent vomiting, and decrease of vision of his left eye prompt us to conduct an urgent craniotomy tumor excision. As the patient had no motor deficit prior to surgery, we chose to do a transcortical approach through the left Kocher’s point, entering the left ventricle, and accessing the tumour from the floor of the frontal horn. The surgery went uneventfully. Following the surgery the patient had no motor weakness, no complaint of headache and vomiting. The visual complaints persisted. And the pathological anatomy resulted in germinoma, in which the patient underwent radiotherapy for the follow up treatment.
Conclusions: Basal ganglia germinoma in adult is a rare occurrence, and due to its location, the surgical approach to access the mass should be individualized in each patient. Transcortical approach from the left Kocher’s point was a safe and accessible approach for our patient. As the tumor was close to important structures such as hypothalamus, thalamus, and basal ganglia, only partial excision was done.
Keywords: Germ cell tumor (GCT); neurosurgery; craniotomy; case report
Acknowledgments
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab065/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
Cite this abstract as: Pangaribuan V, Apriawan T, Azzam M. AB065. Basal ganglia germ cell tumor presenting with visual loss in adult: a case report. Chin Clin Oncol 2024;13(Suppl 1):AB065. doi: 10.21037/cco-24-ab065
