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. 2021 Apr 5;37(5):1449–1459. doi: 10.1007/s00381-021-05148-1

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 6 — Bifocal (suprasellar/pineal) germ cell tumor (BGCT): sagittal T1-contrast-enhanced MRI of a 13-year-old boy presenting with obstructive hydrocephalus and diabetes insipidus. MRI shows a “bifocal–pineal and suprasellar” tumor. A shunt was placed. CSF and blood markers (AFP + BHCG) were negative. Patient was treated for a presumed germinoma and is tumor-free for more than 5 years. One year after shunt insertion, he underwent an endoscopic third ventriculostomy (ETV) due to a shunt malfunction