We report a 23-year-old man with suprasellar germinoma accompanied by optic tract syndrome, Horner's syndrome, and trochlear nerve palsy. Neuroimaging demonstrated that the optic tract, the hypothalamus on the left side, and the trochlear nerve in the subarachnoid space were involved by a germinoma. In addition to neuroimaging findings, detailed observation of various ocular symptoms was highly useful for determining the localization of the germinoma.
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