Roganovic J, Saric L, Segulja S, Dordevic A, Radosevic M. Panhypopituitarism caused by a suprasellar germinoma: A case report. World J Clin Cases 2024; 12(10): 1844-1850 [PMID: 38660086 DOI: 10.12998/wjcc.v12.i10.1844]
Corresponding Author of This Article
Jelena Roganovic, PhD, Adjunct Professor, Department of Pediatrics, Clinical Hospital Centre Rijeka, Istarska 43, Rijeka 51000, Croatia. roganovic.kbcri@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2024; 12(10): 1844-1850 Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1844
Panhypopituitarism caused by a suprasellar germinoma: A case report
Jelena Roganovic, Lea Saric, Silvije Segulja, Ana Dordevic, Mia Radosevic
Jelena Roganovic, Department of Pediatrics, Clinical Hospital Centre Rijeka, Rijeka 51000, Croatia
Jelena Roganovic, Lea Saric, Mia Radosevic, Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
Silvije Segulja, Faculty of Health Sciences, University of Rijeka, Rijeka 51000, Croatia
Ana Dordevic, Department of Business Development, Jadran Galenski Laboratorij, Rijeka 51000, Croatia
Author contributions: Roganovic J designed the study and oversaw patient treatment; Saric L, Dordevic A and Radosevic M collected data; Roganovic J, Saric L, Segulja S, Dordevic A and Radosevic M wrote the paper; Roganovic J was responsible for writing instructions and communication contact; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the parent of the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jelena Roganovic, PhD, Adjunct Professor, Department of Pediatrics, Clinical Hospital Centre Rijeka, Istarska 43, Rijeka 51000, Croatia. roganovic.kbcri@gmail.com
Received: January 4, 2024 Peer-review started: January 4, 2024 First decision: January 17, 2024 Revised: January 31, 2024 Accepted: March 15, 2024 Article in press: March 15, 2024 Published online: April 6, 2024 Processing time: 88 Days and 16.6 Hours
Abstract
BACKGROUND
Suprasellar germinomas are rare intracranial tumors frequently associated with permanent endocrine disorders. We present the clinical picture, treatment, and complications of suprasellar germinoma at pediatric age which, besides being life-threatening, has lifelong endocrinological consequences.
CASE SUMMARY
A 12-year-old female patient was presented having had intensive headaches for three weeks and visual disturbances for six months. An ophthalmological examination revealed bilateral papilledema and a marked loss of vision. Emergency brain magnetic resonance imaging (MRI) showed a suprasellar tumor, involving the infundibulum and the optic chiasm, extending to the third ventricle. Laboratory tests confirmed decreased levels of thyroxine, cortisol, gonadotropins, and insulin-like growth factor 1. Maximal tumor reduction was performed, and immunohistopathology established the diagnosis of suprasellar germinoma. MRI of the spine and cerebrospinal fluid cytology confirmed the localized disease. Adjuvant chemotherapy and radiotherapy were performed according to the SIOP CNS GCT II protocol. A post-treatment MRI showed no residual tumor, but pituitary function had not recovered. Three and a half years after the end of the treatment, the patient is in a complete remission, requiring hormonal replacement therapy, continuous education, and psychological support.
CONCLUSION
This complex case highlights the importance of timely diagnosis, a multidisciplinary approach, and close follow-up in children with suprasellar germinomas.
Core Tip: Suprasellar germinomas are rare tumors that may be associated with hypopituitarism at diagnosis and after therapy. We report the presentation, diagnosis, treatment, and complications of a suprasellar germinoma in a 12-year-old patient. The tumor caused visual impairment, headaches, and hypopituitarism. The patient was treated surgically, followed by adjuvant chemotherapy and radiotherapy. Post-treatment panhypopituitarism required hormonal replacement therapy. The case underscores the complexity of managing these rare tumors and the importance of a multidisciplinary approach. The findings contribute to the understanding of the long-term consequences and holistic lifelong care of pediatric patients with suprasellar germinomas.
