LAUSR

A 28-year-old man presented with progressive right-sided hemiparesis, dystonia, and cognitive impairment for 1 year. An MRI examination of the brain showed severe hemiatrophy in the left hemisphere and brainstem without significant mass lesion (Figure 1). Serum tumor markers, ceruloplasmin, ferritin, CSF immunoglobulin G, lymphocyte subpopulation, encephalitis-related antibodies, and EEG showed negative results. Meanwhile, CT and CT angiography showed no thickened calvarium or cerebrovascular occlusion. After anti-inflammatory treatment for possible Rasmussen encephalitis, his symptoms repeatedly alleviate-recur and gradually deteriorated over a few months, and a repeated MRI showed a diffused lesion that infiltrated the corpus callosum (Figure 2). Pathologic specimens obtained by stereotactic biopsy revealed primary germinoma. Chemoradiotherapy was given, and a 5-year recurrent-free condition was achieved.1,2