# Neoadjuvant Chemotherapy Approach to Pineal Germinoma: A Case Report

## TL;DR

This case report describes a rare pineal germinoma in a 20-year-old man and discusses the challenges in diagnosis and treatment.

## Contribution

The paper presents a rare clinical case of pineal germinoma and highlights the need for standardized treatment approaches.

## Key findings

- The patient was diagnosed with a pineal germinoma after MRI and biopsy.
- A ventriculoperitoneal shunt was used to manage hydrocephalus caused by the tumor.
- No standardized treatment exists for pineal germinomas, necessitating further research.

## Abstract

Intracranial germ cell tumors (GCTs) are rare malignant tumors with a peak incidence around puberty. The pineal region is the most commonly involved area of all intracranial GCTs. Due to the heterogeneous tumor origin, subtypes, and presentation, diagnosis and management are challenging. Complicated pineal germinomas are rarely reported in the literature. Here, we report a rare case of pineal germinoma with hydrocephalus and discuss the potential treatment approach. A 20-year-old boy presented to the hospital with vomiting and a decreased level of consciousness. The brain magnetic resonance imaging (MRI) revealed a pineal tumor. A ventriculoperitoneal shunt was placed to relieve the increased intracranial pressure. The patient underwent a suboccipital craniotomy with excisional biopsy of the pineal region tumor due to its critical location, as imaging studies alone may not be sufficient to establish a definitive diagnosis. Although there has been a rise in reported cases of germinoma tumors, there is currently no standardized therapeutic approach for treating them. Therefore, more randomized controlled cohort studies are necessary to evaluate potential treatments and develop a therapeutic approach.