{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T11:23:18Z","timestamp":1772277798592,"version":"3.50.1"},"reference-count":8,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background:<\/jats:title>\n<jats:p>It is important to differentiate intramedullary neoplastic lesions from nonneoplastic diseases such as multiple sclerosis (MS) and other demyelinating or inflammatory diseases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description:<\/jats:title>\n<jats:p>A 26-year-old Japanese male presented with a history of intracranial germinomas and obstructive hydrocephalus, treated with endoscopic surgery, and adjuvant chemotherapy and radiation therapy. Three years later, he developed paresthesias involving the right hand and both lower extremities. The cervical MR scan demonstrated a heterogeneously enhancing intramedullary C1-C2 lesion with surrounding edema. On cytological examination of the cerebrospinal fluid (CSF), there were no neoplastic cells. However, the fluid was positive for oligoclonal immunoglobulin G (IgG) bands. The patient received steroid pulse therapy to address the potential MS diagnosis. The follow-up MR showed reduced edema, but no change in the size of the intramedullary lesion. Therefore, the patient underwent a cervical laminectomy for tumor resection. The pathology was consistent with the same cranial germinoma treated 3 years previously. He subsequently received whole spinal radiation and three courses of chemotherapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>Some spinal cord tumors may produce oligoclonal IgG bands in CSF. In this case, an intramedullary C1-C2 spinal cord germinoma was originally misdiagnosed as MS due to the presence of oligoclonal IgG bands in CSF. Differentiating this tumor from MS and initiating appropriate treatment were critical into the care of this patient.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_466_2019","type":"journal-article","created":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T07:35:45Z","timestamp":1570779345000},"page":"201","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Intramedullary spinal cord germinoma clinically mimicking multiple sclerosis: A case report"],"prefix":"10.25259","volume":"10","author":[{"given":"Hiroshi","family":"Kageyama","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Shin-Kuki General Hospital, Kuki, Saitama, Japan,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takamoto","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Juntendo Urayasu Hospital, Urayasu, Chiba, Japan,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukou","family":"Ohara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Juntendo University, Hongo, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2019,10,11]]},"reference":[{"key":"10.25259\/SNI_466_2019\/ref-1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1159\/000439028","article-title":"Germinoma mimicking tumefactive demyelinating disease in pediatric patients","volume":"51","author":"Akiyama","year":"2016","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI_466_2019\/ref-2","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s00415-008-0811-0","article-title":"Intracranial germinoma clinically mimicking chronic progressive multiple sclerosis","volume":"255","author":"Birnbaum","year":"2008","journal-title":"J Neurol"},{"key":"10.25259\/SNI_466_2019\/ref-3","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1001\/archneur.57.4.553","article-title":"Cerebrospinal fluid oligoclonal igG bands in patients with spinal arteriovenous malformation and structural central nervous system lesions","volume":"57","author":"Cohen","year":"2000","journal-title":"Arch Neurol"},{"key":"10.25259\/SNI_466_2019\/ref-4","doi-asserted-by":"crossref","first-page":"592","DOI":"10.2176\/nmc.50.592","article-title":"Primary intramedullary spinal cord germinoma","volume":"50","author":"Kinoshita","year":"2010","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_466_2019\/ref-5","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/S1474-4422(02)00225-9","article-title":"Beware of optic neuritis!","volume":"1","author":"Krolak-Salmon","year":"2002","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_466_2019\/ref-6","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/ana.410130112","article-title":"Occurrence of oligoclonal bands in multiple sclerosis and other CNS diseases","volume":"13","author":"Miller","year":"1983","journal-title":"Ann Neurol"},{"key":"10.25259\/SNI_466_2019\/ref-7","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1002\/ana.20703","article-title":"Diagnostic criteria for multiple sclerosis: 2005 revisions to the \u201cMcDonald criteria\u201d","volume":"58","author":"Polman","year":"2005","journal-title":"Ann Neurol"},{"key":"10.25259\/SNI_466_2019\/ref-8","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1136\/jnnp.2008.159483","article-title":"PNS Euronetwork. 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