A Unique Case of Intracranial Bifocal Germinoma.

Primary intracranial germ cell tumors are rare tumors that often occur in children and young adults. We report a case of a 17-year-old male, who presented with vomiting, headache, and blurring of vision of the left eye on the temporal aspect for two months. His biological assessment showed panhypopituitarism. Serum markers showed elevated beta human chorionic gonadotropin and lactate dehydrogenase. A solid cystic lesion was noted on imaging, involving the sella, parasellar region, and pineal region with calcifications within. Diagnosis of bifocal germinoma was confirmed by tumor biopsy. The treatment protocol for the patient involved four cycles of chemotherapy using etoposide and carboplatin, followed by a course of radiotherapy.

Minimally invasive spinal fusion and decompression for thoracolumbar spondylodiscitis.

OBJECTIVE: The objective was to study the results of the treatment of thoracolumbar spondylodiscitis (SD) through minimally invasive fusion and decompression technique. MATERIALS AND METHODS: All the patients were evaluated clinically and radiologically (X-ray, magnetic resonance imaging, and computed tomography scan) along with necessary laboratory investigations. They underwent the minimally invasive spinal (MIS) decompression and fusion procedure using tubular retractor system and percutaneous transpedicular fixation done under fluoroscopy guidance. They were assessed using pre- and postoperative Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Kirkaldy-Willis functional outcome criteria. Postoperative radiological assessment of fusion was done. Operating time and fluoroscopy duration were also studied. RESULTS: There were a total of 12 patients, with an equal sex ratio of 1:1 with 8 and 4 patients having the involvement of the lumbar and dorsal spine, respectively. The fixation was done in the involved vertebrae in 8 patients and adjacent normal vertebrae in 4 patients. There was an improvement in VAS score from 7.8 to 2.1 and ODI from 64.3 to 16.4. 4 patients had excellent, 7 had good, and 1 had fair outcome in Kirkaldy-Willis functional outcome criteria. There was Grade 2 and 3 fusion in 4 cases each, and 2 patients had Grade 4 fusion. The laboratory studies were found positive for tuberculosis in 3 cases with 7 having necrotizing granulomatous inflammation, and 2 patients had negative results. CONCLUSION: The MIS procedure is a safe and effective method of the management of SD in the thoracolumbar spine.