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Brain Germinoma in a Young Adult Man With Suspicion of Fatal Neglect

Kibayashi, Kazuhiko MD*; Sugita, Yasuo MD†; Shojo, Hideki PhD‡; Sumida, Tomomi BMedTech‡

American Journal of Forensic Medicine & Pathology: June 2009 - Volume 30 - Issue 2 - pp 180-182
doi: 10.1097/PAF.0b013e3181875ac5
Case Report

We report a forensic autopsy case of brain germinoma in a 26-year-old man who was severely wasted and initially suspected of fatal neglect. He had a history of nocturnal wandering and was confined by his parents. Neuropathological examination showed germinoma in the hypothalamus and neurohypophysis. The cause of death was certified as hypothalamo-hypophyseal insufficiency due to germinoma. Because hypothalamic lesions may dysregulate feeding behavior and sleeping rhythms, germinoma was considered the causative lesion of the anorexic wasting and nocturnal wandering. Confinement was a preventive measure of the patient's wandering. The findings in this case indicated that hypothalamic tumors should be recognized as a cause of wasting in autopsies suspected of fatal neglect.

From the *Department of Legal Medicine, School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan; the †Department of Pathology, Kurume University School of Medicine, Kurume, Japan; and the ‡Department of Forensic Medicine, Faculty of Medicine, Saga University, Saga, Japan.

Manuscript received May 4, 2007; accepted July 1, 2007.

Supported, in part, by a grant (16390195) from the Japan Society for the Promotion of Science (to K.K.).

All figures can be viewed in color at http://amjforensicmedicine.com.

Reprints: Kazuhiko Kibayashi, MD, Department of Legal Medicine, School of Medicine, Tokyo Women’s Medical University, 8-1 Kawada, Shinjuku, Tokyo 162-8666, Japan. E-mail: kibayash@research.twmu.ac.jp.

© 2009 Lippincott Williams & Wilkins, Inc.