{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:26:37Z","timestamp":1787099197740,"version":"build-2736575974"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"7","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,8,17]]},"abstract":"\n BACKGROUND<\/jats:title>\n Intracranial germinomas are rare tumors, yet they are the most frequent germ cell tumors in the CNS. They typically occur along the midline, including areas like the suprasellar region, pineal gland, and basal ganglia. Tumors in the suprasellar region often present with visual and endocrine impairments.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n This article discusses the case of a 25-year-old patient with a tumor located in the suprasellar region, for whom an endoscopic endonasal approach was selected, with the preoperative objective of resection, owing to the suspicion of a craniopharyngioma. However, based on intraoperative findings, this diagnosis was excluded, prompting us to consider a germinoma, and the procedure was concluded with a biopsy. Postoperatively, the patient received chemoradiotherapy, resulting in a favorable resolution of the condition, improvement of symptoms, and a complete response observed on follow-up MRI.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case highlights three clinically actionable teaching points: arginine vasopressin deficiency (AVP-D) and anterior pituitary dysfunction in a young patient with a suprasellar mass should raise suspicion for germinoma, glucocorticoid replacement may unmask AVP-D by reversing cortisol deficiency\u2013mediated antidiuresis, and the surgeon must be prepared to make real-time decisions based on intraoperative findings during endoscopic endonasal surgery.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2677<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2677","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:01:19Z","timestamp":1787097679000},"source":"Crossref","is-referenced-by-count":0,"title":["Suprasellar germinoma: intraoperative findings from an endoscopic endonasal approach. Illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8539-3509","authenticated-orcid":true,"given":"Eduardo","family":"Ichikawa-Escamilla","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Medical Center, XXI Century, Specialties Hospital, Instituto Mexicano del Seguro Social, Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ramos-Escalante","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Medical Center, XXI Century, Specialties Hospital, Instituto Mexicano del Seguro Social, Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"Correa-Correa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Medical Center, XXI Century, Specialties Hospital, Instituto Mexicano del Seguro Social, Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas E.","family":"Falc\u00f3n-Molina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Medical Center, XXI Century, Specialties Hospital, Instituto Mexicano del Seguro Social, Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Ramzes","family":"Ch\u00e1vez-Herrera","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Medical Center, XXI Century, Specialties Hospital, Instituto Mexicano del Seguro Social, Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Ram\u00f3n","family":"Garc\u00eda-Sa\u00e9nz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, National Medical Center, XXI Century, Specialties Hospital, Instituto Mexicano del Seguro Social, Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-8941","authenticated-orcid":true,"given":"Gerardo Y.","family":"Guinto-Nishimura","sequence":"additional","affiliation":[{"name":"National Institute of Neurology and Neurosurgery, \u201cManuel Velasco Su\u00e1rez,\u201d Ciudad de M\u00e9xico, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Proc (Bayl Univ Med Cent)","first-page":"43","article-title":"Intracranial germinoma","volume":"28","author":"Reddy","year":"2015","unstructured":"Reddy MPSaad AFDoughty KEIntracranial germinoma. Proc (Bayl Univ Med Cent). 2015;28(1):43-45. doi:10.1080\/08998280.2015.11929183"},{"issue":"2","key":"bib2","series-title":"J Neurooncol","first-page":"251","article-title":"Descriptive epidemiology of germ cell tumors of the central nervous system diagnosed in the United States from 2006 to 2015","volume":"143","author":"Gittleman","year":"2019","unstructured":"Gittleman HCioffi GVecchione-Koval TDescriptive epidemiology of germ cell tumors of the central nervous system diagnosed in the United States from 2006 to 2015. J Neurooncol. 2019;143(2):251-260. doi:10.1007\/s11060-019-03173-4"},{"issue":"8","key":"bib3","series-title":"Acta Neurochir (Wien)","first-page":"1699","article-title":"Endonasal surgery for suprasellar germ cell tumors: two cases and review of the \u00adliterature","volume":"161","author":"Arnaout","year":"2019","unstructured":"Arnaout MMGerges MMCummock MDEndonasal surgery for suprasellar germ cell tumors: two cases and review of the \u00adliterature. Acta Neurochir (Wien). 2019;161(8):1699-1704. doi:10.1007\/s00701-019-03969-3"},{"key":"bib4","series-title":"Clin Neurol Neurosurg","first-page":"106026","article-title":"Suprasellar germinoma with hypopituitarism in an 18-year old man: a case report and review of literature","volume":"196","author":"Celik","year":"2020","unstructured":"Celik OOzyurt SSaglican Y.Suprasellar germinoma with hypopituitarism in an 18-year old man: a case report and review of literature. Clin Neurol Neurosurg. 2020;196:106026. doi:10.1016\/j.clineuro.2020.106026"},{"issue":"7","key":"bib5","series-title":"Curr Oncol Rep","first-page":"765","article-title":"Intracranial germinomas: diagnosis, pathogenesis, clinical presentation, and management","volume":"25","author":"Kremenevski","year":"2023","unstructured":"Kremenevski NBuchfelder MHore N.Intracranial germinomas: diagnosis, pathogenesis, clinical presentation, and management. Curr Oncol Rep. 2023;25(7):765-775. doi:10.1007\/s11912-023-01416-2"},{"key":"bib6","series-title":"Front Endocrinol (Lausanne)","first-page":"789109","article-title":"Intracranial germinoma misdiagnosed as hyperthyroidism: a case report and review of the literature","volume":"12","author":"Tian","year":"2021","unstructured":"Tian JWu JYan ZHuang H.Intracranial germinoma misdiagnosed as hyperthyroidism: a case report and review of the literature. Front Endocrinol (Lausanne). 2021;12:789109. doi:10.3389\/fendo.2021.789109"},{"key":"bib7","series-title":"World Neurosurg","first-page":"165","article-title":"Suprasellar germinomas: 2 case reports and literature review","volume":"117","author":"Mesquita Filho","year":"2018","unstructured":"Mesquita Filho PMSantos FPK\u00f6hler LRSuprasellar germinomas: 2 case reports and literature review. 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