text: Neurohypophyseal granulomatous germinoma invading the right cavernous sinus: case report and review of the literature.
  We encountered a rare case of neurohypophyseal germinoma with a prominent granulomatous reaction, which invaded the right cavernous sinus. The neuroimaging and histopathology features in this case were unique, distinguishing it from other types of suprasellar lesions. A 13-year-old boy presented with loss of appetite and polyuria; both symptoms were present for 1 year, and headache, general fatigue and blurred vision present for the prior 2 months. On admission, neurological examination indicated bitemporal hemianopsia and optic atrophy. Endocrinological exam showed panhypopituitarism. Tumor markers such as alpha-fetoprotein, human growth hormone, carcinoembryonic antigen, and placental alkaline phosphatase were negative. Brain CT revealed a suprasellar tumor with calcification. MR T(1)-weighted and T(2)-weighted images showed the tumor to be isointense to normal brain parenchyma and to be enhanced densely. The tumor also involved the right cavernous sinus, so that a biopsy was performed by the transsphenoidal approach. On pathologic examination of the specimen, typical large tumor cells with lymphocytic cell infiltration and prominent granulomatous reaction were observed. Neurohypophyseal granulomatous germinoma was diagnosed. Radiotherapy was performed with a total dose of 51 Gy and the tumor shrank remarkably. The patient returned to school under hormone replacement therapy.
  
entities: ['Neurohypophyseal granulomatous germinoma']
entities: Pathological_formation
entities: PMID-17627146_T1
entities: ['right cavernous sinus']
entities: Immaterial_anatomical_entity
entities: PMID-17627146_T2
entities: ['neurohypophyseal germinoma']
entities: Pathological_formation
entities: PMID-17627146_T3
entities: ['right cavernous sinus']
entities: Immaterial_anatomical_entity
entities: PMID-17627146_T4
entities: ['suprasellar lesions']
entities: Pathological_formation
entities: PMID-17627146_T5
entities: ['Tumor']
entities: Pathological_formation
entities: PMID-17627146_T6
entities: ['placental']
entities: Organ
entities: PMID-17627146_T8
entities: ['Brain']
entities: Organ
entities: PMID-17627146_T9
entities: ['suprasellar tumor']
entities: Pathological_formation
entities: PMID-17627146_T10
entities: ['tumor']
entities: Pathological_formation
entities: PMID-17627146_T11
entities: ['brain']
entities: Organ
entities: PMID-17627146_T12
entities: ['tumor']
entities: Pathological_formation
entities: PMID-17627146_T13
entities: ['right cavernous sinus']
entities: Immaterial_anatomical_entity
entities: PMID-17627146_T14
entities: ['transsphenoidal']
entities: Multi-tissue_structure
entities: PMID-17627146_T15
entities: ['tumor cells']
entities: Cell
entities: PMID-17627146_T16
entities: ['lymphocytic cell']
entities: Cell
entities: PMID-17627146_T17
entities: ['Neurohypophyseal granulomatous germinoma']
entities: Pathological_formation
entities: PMID-17627146_T18
entities: ['tumor']
entities: Pathological_formation
entities: PMID-17627146_T19