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Germinoma presenting as a fourth cranial nerve palsy in a p..:

Lima, Breno Rocha ; Schoenfield, Lynn ; Rychwalski, Paul J.
Journal of American Association for Pediatric Ophthalmology and Strabismus.  15 (2011)  1 - p. 71-73 , 2011
Link: https://doi.org/10.1016/j.jaapos.2010.11.004