{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:43:33Z","timestamp":1773787413728,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:00:00Z","timestamp":1760227200000},"content-version":"vor","delay-in-days":284,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Intracranial germ cell tumors (GCTs) are rare in the pediatric population. They are classified as germinoma and nongerminomatous and may secrete specific proteins such as\n                      <jats:italic>\u03b2<\/jats:italic>\n                      subunit of human chorionic gonadotropin (\u03b2\u2010hCG) and alpha\u2010fetoprotein (AFP). When secreting\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2010hCG, they may induce gonadotropin\u2010independent puberty (GIP), a clinical diagnostic clue that can precede neuroimaging findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>\n                      A 13\u2010year\u2010old boy presented with a first generalized tonic\u2013clonic seizure after six months of headaches, vomiting, polyuria, and polydipsia. Examination showed pubertal penile length with peripubertal testes. Laboratory assessment revealed panhypopituitarism with suppressed gonadotropins and elevated testosterone. Brain magnetic resonance imaging (MRI) demonstrated bifocal lesions (pineal and suprasellar) with obstructive hydrocephalus. Cerebrospinal fluid (CSF) sample obtained via temporary external ventricular drain (EVD) showed a normal cytology, confirming a\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2010hCG\u2010secreting germinoma. The patient achieved remission after chemotherapy, neurosurgical resection, and cranial radiotherapy. He developed a posterior medulla relapse successfully salvaged with gemcitabine\u2013paclitaxel\u2013oxaliplatin, high\u2010dose etoposide\u2013thiotepa with autologous stem\u2010cell transplantation, and craniospinal irradiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Discordant clinical and biochemical puberty (penile enlargement with small testes and high testosterone with suppressed gonadotropins) should prompt\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2010hCG testing and targeted neuroimaging for suspected central nervous system GCTs. When raised intracranial pressure precludes lumbar puncture, CSF sampling via EVD is a safe alternative. Coordinated oncologic\u2013endocrine care supports durable disease control with tailored long\u2010term hormonal follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crpe\/5815092","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T06:29:45Z","timestamp":1760336985000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bifocal\n                    <i>\u03b2<\/i>\n                    \u2010hCG\u2010secreting CNS Germinoma in a 13\u2010Year\u2010Old Boy: Clinical\u2013Biochemical Pubertal Discordance and Long\u2010Term Outcome"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7197-3078","authenticated-orcid":false,"given":"Corina Ramona","family":"Nicolescu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine Thouvenin","family":"Doulet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucie","family":"Bazus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Louis","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,12]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2008-0037"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1215\/15228517-2007-054"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1985.63.2.0155"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab252"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30168"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-022-03121-9"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-21-0381"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ21-0117"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpem.2001.14.6.789"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.80.12.8530631"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1994.81.4.0601"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1977.47.1.0101"},{"key":"e_1_2_12_13_2","volume-title":"Williams Textbook of Endocrinology","author":"Styne D. 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