Diabetes insipidus with impaired vision caused by germinoma and perioptic meningeal seeding:A case report  

作　　者：Na Yang Hui-Juan Zhu Yong Yao Li-Yun He Yu-Xiu Li Hui You Hua-Bing Zhang 

机构地区：[1]Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China [2]Department of Neurosurgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China [3]Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China

出　　处：《World Journal of Clinical Cases》2021年第8期1976-1982,共7页世界临床病例杂志

基　　金：Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences,No.2019XK320029;National Natural Science Foundation of China,No.91846106;Education and Teaching Reform Project of Peking Union Medical College,No.2014zlgc0316.

摘　　要：BACKGROUND Germinoma is a type of germ cell tumor that most frequently arises in the midline axis of the brain.Impaired vision is a clinical manifestation of germinnoma.Although rare,intracranial germinoma seeding to the perioptic arachnoid space is one cause of visual acuity decrease.CASE SUMMARY An 11yearold girl who presented with polyuria and polydipsia and subsequently developed diminution of vision.Imaging showed bilateral heterogeneous enhancement of the optic nerve sheaths and atrophy of the optic nerve,and transsphenoidal biopsy revealed a germinoma.The patient experienced poor visual recovery following chemotherapy and radiotherapy.Germinomas are rare and they are mostly identified in children and adolescents.The manifestations include diabetes insipidus,pituitary dysfunction,visual complaints,etc.The mechanisms that lead to visual loss include intracranial hypertension,compression of optic chiasma,and tumor invasion.A literature review was performed to summarize the cases with a tumor infiltrating the optic nerve.Most of the reported patients were adolescents and presented with anterior pituitary hormone deficiency.Enhancement of optic nerve sheaths and optic disc pallor could be identified in most of the cases.The purpose of this report is to provide awareness that in cases where a germinoma is associated with visual loss,though rare,perioptic meningeal seeding should be taken into consideration.CONCLUSION The case report suggests that children with diabetes insipidus need a complete differential diagnosis.

关 键 词：GERMINOMA Visual acuity decrease Central diabetes insipidus Perioptic meningeal seeding Intracranial tumor Case report 

分 类 号：R739.41[医药卫生—肿瘤]