A 40-year-old woman with a progressive periventricular white matter lesion

Jeroen de Jong, Hans Stoop, Martin van den Bent, Johan M Kros, J Wolter Oosterhuis, Leendert H J Looijenga

Research output: Contribution to journalArticlepeer-review


A 40-year-old woman presented with blurred vision and diplopia, followed by slowly progressive left-sided motor and sensory disturbances. She also suffered from memory loss and had mild spatial and temporal disorientation. A T2-weighted MRI showed a large area of high signal intensity in the periventricular white matter of the right more than the left occipital region and the corpus callosum, without enhancement on T1-weighted images after gadolinium administration and without mass effect. A stereotacticbiopsy of the intracerebral lesion showed blast-like neoplastic cells within a mononuclear infiltrate. No diagnosis could be made based on morphology and immunohistochemistry using a large series of markers. However, based on positive OCT3/4 nuclear staining, the tumor was diagnosed as a germinoma (seminoma of the brain). The patient was treated accordingly and her condition improved, although focal deficits remained.

Original languageEnglish
Pages (from-to)103-4, 142
Number of pages2
JournalBrain Pathology
Issue number1
Publication statusPublished - Jan 2008
Externally publishedYes


  • Adult
  • Biomarkers, Tumor/analysis
  • Brain Neoplasms/metabolism
  • Cerebrum/metabolism
  • Diagnosis, Differential
  • Disease Progression
  • Early Diagnosis
  • Female
  • Germinoma/metabolism
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasm Invasiveness/diagnostic imaging
  • Neoplasm Recurrence, Local
  • Nerve Fibers, Myelinated/metabolism
  • Neurosurgical Procedures
  • Octamer Transcription Factor-3/analysis
  • Predictive Value of Tests
  • Radiography
  • Remission Induction
  • Vision, Low/etiology
  • Visual Pathways/pathology


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