Korean J Radiol.  2008 Jul;9(Suppl):S26-S29. 10.3348/kjr.2008.9.s.s26.

Congenital Cerebellar Mixed Germ Cell Tumor Presenting with Hemorrhage in a Newborn

• Kim SM
• Kim JH
• Yoo SY
• Park WS
• Jang YS
• Shin HJ
• Suh YL

• KMID: 1100099
• DOI: http://doi.org/10.3348/kjr.2008.9.s.s26

Abstract

We report here on a neonate with congenital cerebellar mixed germ cell tumor, and this initially presented as cerebellar hemorrhage. Postnatal cranial ultrasonography revealed an echogenic cerebellar mass that exhibited the signal characteristics of hemorrhage rather than tumor on MR images. The short-term follow-up images also suggested a resolving cerebellar hemorrhage. One month later, the neonate developed vomiting. A second set of MR images demonstrated an enlarged mass that exhibited changed signal intensity at the same site, which suggested a neoplasm. Histological examination after the surgical resection revealed a mixed germ cell tumor.

Keyword

Congenital cerebellar tumor; Mixed germ cell tumor; Posterior fossa tumor; Neonatal cerebellar hemorrhage

MeSH Terms

Cerebellar Diseases/*etiology
Cerebellar Neoplasms/*congenital/diagnosis/ultrasonography
Cerebral Hemorrhage/*etiology
Female
Humans
Infant, Newborn
Magnetic Resonance Imaging
Neoplasms, Germ Cell and Embryonal/*congenital/diagnosis/ultrasonography

Figure

• 

  Fig. 1 Mixed germ cell tumor presenting with hemorrhage in newborn. A, B. Postnatal sagittal sonogram (A) of brain on second day of life demonstrates homogeneous echogenic midline cerebellar mass that is inseparable from echogenic vermis. Coronal Doppler sonogram (B) shows no vascular flow in mass. C-E. Brain MR images obtained on same day as US demonstrate cerebellar vermian mass exhibiting isosignal intensity on T1-weighted images (C) and this is darkened on T2-weighted image (D). There is no enhancement after administration of contrast medium (E). MR findings were consistent with hematoma. F. Brain CT obtained 26 days after US demonstrates non-enhancing low-attenuated mass with slight reduction of volume. G, H. One month after CT scan, mass appears larger and it shows heterogeneous high signal intensity on T2-weighted images (G) and post-contrast T1-weighted images (H). Findings are consistent with neoplasm. I, J. This tumor consists mainly of immature neuroectodermal tissue, immature cartilage and mesenchymal tissue (I, Hematoxylin & Eosin staining, ×40) as well as yolk sac tumor (arrows) that consists of small neoplastic cells that are separated by myxoid stroma (J, Hematoxylin & Eosin staining, ×200).

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