A 28-year-old woman, 1 month post partum, who presented with headache and gradual onset of total ophthalmoplegia of the left eye, was found at transsphenoidal exploration to have a primary intrasellar germinoma. Craniospinal irradiation resulted in complete resolution of the intracranial tumor. Extensive mediastinal metastasis at 8 months after the operation resulted in a fatal outcome.