BACKGROUND: Although the usefulness of susceptibility-weighted imaging (SWI) for detecting basal @entity3438 has been reported, the technique is not widely used. We recently encountered an unusual case of primary @entity76 , presenting with progressive @entity2055 and @entity129 , characterized by gradually enlarging low-intensity lesions visible with both T2*-weighted imaging (T2*WI), which were the key to the diagnosis. CASE PRESENTATION: A 30-year-old @entity1 was referred to our hospital because of slowly progressive @entity1296 and mild @entity2055 . Magnetic resonance imaging (MRI) revealed a small, low-intensity spot in the left cerebellar peduncle on the T2*WI and SWI without enhancement. Cerebral angiography revealed no @entity455 . The serum a-fetoprotein value was normal. A @entity479 -pulse was administered as a therapeutic and diagnostic trial, but the symptoms improved little. The @entity1 was discharged from the hospital but soon developed @entity409 , characterized by @entity1353 or @entity11637 , and he was readmitted. T2*WI imaging revealed expanded and extended spotty lesions in the cerebellum and brainstem, which had not enhanced with contrast agent previously. Targeted stereotactic biopsy of the newly enhanced @entity76 was performed; histopathological examination of the tissue revealed @entity3438 . Serum and cerebral spinal fluid values of beta- @entity1 chorionic gonadotropin were not significantly elevated. Chemotherapy with @entity3003 and @entity2879 was initiated. The enhanced @entity75 disappeared promptly, but the @entity1 continued to require assisted automatic ventilation because of @entity912 of respiratory muscles. CONCLUSIONS: We conclude that enlarging low-intensity lesions on T2*WI and SWI may be a reliable clue to the diagnosis of @entity3438 , irrespective of their location, even without enhancement. Biopsy of the @entity5 at an early stage is the only way to make the diagnosis conclusively and enable prompt start of treatment.

Radiographic @entity76 presenting with progressive XXXX and @entity129 .

@entity129 :: ('MESH:D003389', 'Disease') :: ['cranial nerve palsy'] @entity1 :: ('9606', 'Species') :: ['human', 'patient', 'man'] @entity455 :: ('MESH:D014652', 'Disease') :: ['vascular abnormality'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['dyspnea'] @entity75 :: ('MESH:D001927', 'Disease') :: ['lesion'] @entity3003 :: ('MESH:D016190', 'Chemical') :: ['carboplatin'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity409 :: ('MESH:D008107', 'Disease') :: ['brainstem dysfunction'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity3438 :: ('MESH:D018237', 'Disease') :: ['pure germinoma', 'germinomas', 'ganglia germinoma'] @entity11637 :: ('MESH:D006606', 'Disease') :: ['hiccups'] @entity76 :: ('MESH:D002526', 'Disease') :: ['cerebellar lesion', 'cerebellar germinoma'] @entity1296 :: ('MESH:D004244', 'Disease') :: ['dizziness'] @entity912 :: ('MESH:D010243', 'Disease') :: ['paralysis'] @entity2055 :: ('MESH:D001259', 'Disease') :: ['ataxia'] @entity479 :: ('D013256', 'Chemical') :: ['steroid']
@entity2055 :: (MESH:D001259,Disease) :: ['ataxia']
