ABSTRACT
Intracranial mixed germ cell tumours, particularly with the occurrence of germinoma and teratoma components, are very rare. On many occasions, the diagnosis is only reached after a second surgical resection of what is believed to be a tumour recurrence. The authors report two young adolescent males who presented with headache, vomiting and Parinaud's syndrome. Cranial CT and MRI scans demonstrated a large heterogeneous pineal region tumour. Through a supracerebellar infratentorial approach, in both patients, a complete excision of the tumour was achieved of a histopathologically proven mixed germ cell tumour, predominantly teratoma with elements of germinoma. The patients received adjuvant chemotherapy and radiotherapy and remained tumour free during their follow-up. The authors discuss the management of this rare entity and emphasize the importance of detailed histopathological examination