Abstract：Objective: To study imaging features of suprasellar germinoma, and analyse the reasons of diagnostic error. Methods: The imaging findings of 14 misdiagnosed and pathologically confirmed suprasellar germinoma cases were retrospectively reviewed. The most common causes of diagnostic error were analysed. Results: Teenagers(mean age 15.5y) and female patients(n=8) were more common in these suprasellar germinoma patients, clinical features including visual loss(n=7) and hypothalamic-pituitary dysfunction symptoms, such as polydipsia, polyuria(n=8) and amenorrhea(n=3). Sometimes serum or cerebrospinal fluid β-HCG elevation could be recognized(n=4). The tumors were mainly solid(n=10), cystic change(n=4) could be seen in some cases. Calcification(n=2) was rare. They showed slightly high density on CT scan, iso-high signal on MRI scan. The lesions were usually obviously and homogenously enhanced(n=7). The common causes of misdiagnosis include: ①unconfirmed diagnosis because of incomplete imaging examination(n=6), ②craniopharyngioma due to calcification or age(n=6), ③pituitary adenoma because of "snowman sign"(n=3), ④glioma because of age or other reasons(n=3). Conclusion: Suprasellar germinoma tends to be misdiagnosed as craniopharyngioma, pituitary adenoma, or glioma. Correct diagnosis of suprasellar germinoma should base on complete imaging examination and in the meanwhile, patient's age, clinical symptoms, laboratory examination should be taken into consideration.
2011, Vol. 22 
