Abstract
A young woman presented with significant weight loss and malnutrition secondary to decreased food intake. Her presentation was felt to be consistent with a psychiatric diagnosis of avoidant restrictive food intake disorder (ARFID). She received 3 years of treatment for ARFID, but failed to make significant progress and ultimately required a feeding tube. Incidentally, she noted severe visual field changes at this time, which triggered further workup including an MRI of the head. This revealed the true diagnosis of a suprasellar and pineal germinoma. There are several cases in the literature of germinomas presenting with decreased food intake that were misdiagnosed as anorexia nervosa. However, this is the first reported case of a multifocal germinoma presenting as ARFID. Criteria for the diagnosis of ARFID do not include body image distortion, potentially making this eating disorder more prone to misdiagnosis.
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HMM was responsible for assessing the patient on initial presentation, obtaining consent from the patient, collecting data from the patient’s chart, performing a literature review, and writing the manuscript. TL was responsible for assessing the patient on initial presentation, performing initial investigations, synthesizing the data, and writing/editing the manuscript. LLB was responsible for assessing and providing ongoing management to the patient, synthesizing the data, and writing/editing the manuscript.
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McDonald, H.M., Lin, T. & Bursztyn, L.L.C.D. Multifocal germinoma masquerading as avoidant restrictive food intake disorder: a case of severely decreased food intake and malnutrition. Eur J Clin Nutr 76, 173–176 (2022). https://doi.org/10.1038/s41430-021-00896-4
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DOI: https://doi.org/10.1038/s41430-021-00896-4