Is Regression of Intracranial Germinoma Spontaneous or Diagnostic Radiation-Induced? A Case Report
Bibliographic record
Abstract
Although several case reports describ ing about “spontaneous” regression of primary intracranial germinoma are available, intensive analysis of those reports suggests diagnostic radiation as a possible cause of the regression in those reports. We present a case of regression of intracranial germinoma, which advocates diagnostic radiation as a cause of previously reported regression of intracranial germinoma. A 22-year-old female student was forced to repeat a grade in school due to unusual fatigue. Despite 4-year absence of her menstrual period as a woman of reproductive age, she did not receive medical attention until experiencing unusual fatigue with visual disturbance and undermined learning. Initial endocrinological work-up revealed panhypopituitarism with masked diabetes insipidus. Magnetic resonance imaging showed a suprasellar tumor, involving the neurohypophysis, optic chiasm and hypothalamus, with spinal dissemination. Endoscopic transnasal biopsy provided pathological confirmation of germinoma, which was treated with craniospinal irradiation. Regression of the suprasellar lesion after cranial computed tomography during radiation therapy planning was demonstrated on serial magnetic resonance imaging. The patient obtained remission and regained a nearly normal level of activity under hormone replacement therapy, but restriction of her visual fields did not improve sufficiently. Diagnostic radiation can induce the regression of intracranial germinoma. Clinicians should keep this diagnostic radiation-induced regression of germinoma in mind and should eliminate unnecessary irradiation to germinoma throughout the diagnostic process. Inadvertent diagnostic radiation can hide fine lesions to be treated. J Neurol Res. 2014;4(1):41-48 doi: http://dx.doi.org/10.14740/jnr264w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".