Abstract
We report a case of intracranial embryonal carcinoma mimicking a HCG-producing germinoma. This 23-year-old male developed double vision, nausea, vomiting, and headache over the course of several days and was transferred to our department. CT and MRI revealed a partially calcified, well-circumscribed, markedly enhanced, homogeneous mass in the pineal region with obstructive hydrocephalus. Clinical diagnosis was HCG-producing germinoma, since his serum titer of human chorionic gonadotropin HCG was slightly elevated (9.9mIU/ml) and that of α-fetoprotein (AFP) remained within the normal range. He underwent partial removal of the tumor, which was histologically verified as embryonal carcinoma. Although residual tumor disappeared completely after 4 courses of chemotherapy consisting of ifosphamide, CDDP, and etoposide in combination with radiotherapy to the whole neural axis, he died of a recurrent tumor 6 months after the initial diagnosis. It is necessary to establish the comprehensive management for embryonal carcinoma, including diagnostic surgery, because patients with embryonal carcinoma infrequently have the characters of markedly elevated serum titers of HCG and/or AFP ; symptoms of which are also observed in those with yolk sac tumor or choriocarcinoma.
