An Unusual Case of Pure Germinoma in a Patient With Tourette's Syndrome

HD Pacholke, DW Pincus, NP Mendenhall

Hong Kong J Radiol 2003;6:155-7

Tourette’s syndrome is a rare, neuropsychiatric disorder of complex aetiology. Although the exact mechanism is not completely understood, neuroendocrine dysfunction is related to the pathogenesis of Tourette’s syndrome. Clinical characteristics of the disorder, including motor tics and coprolalia, are associated with dysregulation of dopamine, melatonin, acetylcholine and/or endogenous opioids produced in the midbrain and epithalamus. The authors present a case of pure germinoma of the pineal gland with synchronous involvement of the nasal cavity and suprasellar region in a 20-year-old man with Tourette’s syndrome. This case report illustrates the theory that alterations in the production and regulation of endogenous hormones produced by the midbrain, pineal gland, and periaqueductal grey matter may be linked to the phenotype of Tourette’s syndrome.