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The most common tumors of the pineal region are germinomas, and they make up two thirds of all intracranial germ tumors. The incidence of tumors of the pineal region is the highest in population between twenty and thirty years of age. The clinical presentation of tumors of pineal region corresponding to the symptoms and signs of increased intracranial pressure with typical manifestations for pineal region tumors. In our paper a male patient, twenty years old, was hospitalized because of dizziness, persistent vomiting, instability when walking, confusion and impaired hearing. By using computed tomography intracranial expansive process were diagnosed, localized in the fourth and third cerebral chamber and in pineal region, with radiological signs of internal hydrocephalus. Following the ventriculoperitoneal shunt surgical procedure, tumor reductive surgery was conducted. Histopathological finding indicated that this was germinoma. During the postoperative period radiotherapy was conducted as well. Control neuroimaging procedures did not indicate the existence of rest, nor recurrent tumor. The tumor presented in this paper had been clinically silent for long, which is the peculiarity of the case. The outcome of surgically treating germinoma, which follow the radiotherapy and chemotherapy, is very good, especially if the tumor is diagnosed at an early stage, as evidenced by the case presented here.

Extreme propagation pineal region germinoma in fourth cerebral ventricle