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Objective: To describe a case with a rare form of bifocal mixed germ cell tumor, interesting both pineal and sellar regions, with symptoms of increased intracranial pressure, neurological disorders, endocrine abnormalities with panhypopituitarism and a particular trend in pubertal development that probably progressed supported by β-HCG secretion by the tumor. Methods: Brain MRI, biopsy and histological examination were performed, revealing the presence of a germ cells tumor compatible with dysgerminoma with a component of embrional carcinoma. After initiation of replacement therapy for panhypopituitarism, the patient received chemotherapy and radiotherapy. Results: Treatment showed tumor regression and the patient is currently on desmopressin, hydrocortisone, L-thyroxine and GH replacement therapies. He is currently followed at the adult’s Unit, with no further relapses 7 years after the diagnosis. Conclusions: The IGCTs are very rare; combined imaging, laboratory and histological diagnosis is needed for a correct diagnosis and to define the approach that will be used. One of the main challenges will be to minimize the side effects of treatment in order to improve the quality of life of these patients.

Cerebral Germinoma as a cause of Abnormal Pubertal Development in a 16 years Old Boy