Clinical and Laboratory ObservationsMetachronous Mediastinal Seminoma Occurring After Intracranial Germinoma in an AdolescentAyyanar, Kanyalakshmi MD*; Blackman, Samuel C. MD, PhD†; Chordas, Christine PNP†; Frazier, Lindsay MD†; Kieran, Mark W. MD, PhD†Author Information *Division of Pediatric Hematology/Oncology, Kosair Children's Hospital, University of Louisville, KY †Division of Pediatric Oncology, Dana-Farber Cancer Institute and Children's Hospital, Boston, MA Reprints: Kanyalakshmi Ayyanar, MD, Division of Pediatric Hematology/Oncology, Kosair Childrens Hospital, University of Louisville, 571 South Floyd Street, Suite No. 445, Louisville, KY-40202 (e-mail: email@example.com). Received for publication May 23, 2008 accepted April 11, 2009 Journal of Pediatric Hematology/Oncology: November 2009 - Volume 31 - Issue 11 - p 861-864 doi: 10.1097/MPH.0b013e3181b1ed2b Buy Metrics Abstract We report a case of a mediastinal seminoma occurring 19 months after the resolution of a pineal germinoma. A 15-year-old boy with headaches and visual changes was diagnosed with a pineal germinoma by biopsy and mildly elevated β-human chorionic gonadatropin (β-HCG) in serum and cerebral spinal fluid. Radiation therapy leads to the resolution of his pineal germinoma and normalization of the β-HCG. A mediastinal seminoma (germinoma) was diagnosed nearly 2 years later because of rising serum β-HCG. There was no evidence of recurrent central nervous system disease. The patient underwent systemic chemotherapy with the complete resolution of the mediastinal seminoma. © 2009 Lippincott Williams & Wilkins, Inc.