A Case of Suprasellar Germinoma Metastasized to the Epidural Space of the Lumar Spinal Canal: Report of a Case

ABSTRACT

We have experienced a case of suprasellar germinoma metastasized to the lumbar spinal canal. A 22-year-old man was admitted to St. Mary's Hospital May, 1975 with complaints of low back pain, progressive weakness of both lower extremities and voiding difficulty for about one month. About 7 months ago he received craniotomy and irradiation therapy for suprasellar germinoma. Neurological examination revealed foot drop on the left side with sensory change and atonic neurogenic bladder. Pantopaque myelogram showed a total block at the level of the 3 rd lumbar vertebra suggestive an epidural mass compressing dural sac posteriolaterally. Total laminectomy of lumbar first to fifth vertebrae disclosed a firm, rubbery hard and vascular mass in the epidural space, which was not adherent to the dura. Histological examination of the tumor revealed typical germinoma. Pathogenesis of geminoma and possible mode of epidural metastasis are discussed.