Shahrir et al. Journal of Medical Case Reports 2010, 4:97 http://www.jmedicalcasereports.com/content/4/1/97 Page 2 of 2 Figure 1 An image of our patient’s pituitary showing polymorphic cells with granular cytoplasm. Discussion This case study is unusual because our patient had both SLE and pituitary germ cell tumor. It is also unusual because when our patient’s pituitary function was dis- rupted, her lupus nephritis went into remission. Initially, it was thought that the two mechanisms responsible for her amenorrhoea were gonadal injury secondary to SLE insult and cyclophosphamide usage. However, our patient’s amenorrhoea was due to the pituitary involvement and its effect on her ovaries. At the same time, her SLE was also in remission. This can be explained by the fact that the reduction in immunor- egulatory functions of estradiol, testosterone, progester- one, dehydroepiandrosterone (DHEA) and prolactin had resulted in the remission of our patient’s SLE [4]. Conclusion The functional disruption of the pituitary-gonadal com- plex could affect SLE activity by reducing our patient’s hormonal immunoregulation. Consent Written informed consent was obtained from our patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Authors’ contributions All the authors contributed to the management of the patient. Additionally, MS was the primary author of the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 24 October 2008 Accepted: 25 March 2010 Published: 25 March 2010 References 1. Takeda S, Miyoshi S, Ohta M, Minami , Masaoka M, Matsuda H: Primary germ cell tumors in the mediastinum: a 50-year experience at a single Japanese institution. Cancer 2003, 97(2):367-376. 2. Droz JP, Horwich A: Extragonadal germ cell tumors. Comprehensive Textbook of Genitourinary Oncology New York: Lippincott Williams and WilkinsVogelzang NJ, Scardino PT, Shipley WU, Doffey DS , 2 2000. 3. Hasle H, Mellemgaard A, Nielsen J, Hansen J: Cancer incidence in men with Klinefelter syndrome. Br J Cancer 1995, 71(2):416-420. 4. McMurray RW, May W: Sex hormones and systemic lupus erythematosus: review and meta-analysis. Arthritis Rheum 2003, 48:2100. doi:10.1186/1752-1947-4-97 Cite this article as: Shahrir et al.: Extragonadal germ cell tumor presenting in a woman with systemic lupus erythematosus: a case report. Journal of Medical Case Reports 2010 4:97. Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color ﬁgure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution Submit your manuscript at www.biomedcentral.com/submit