Maruki C, Takara K, Abe K, Tsunoda A, Ebato M, Ikeya F
Department of Neurosurgery, Koshigaya Municipal Hospital, Saitama, Japan.
No Shinkei Geka. 2000 Oct;28(10):909-12.
A case of a primary pineal embryonal carcinoma occurring in a middle aged man is reported. A 42-year-old man suffering from headache and nausea was referred to our department. A neurological examination revealed that he had Parinaud's sign. Head CT and MRI showed a tumor in the pineal region. He was operated on using the occipital trans-tentorial approach. The tumor was partially removed and an intra-operative specimen was used to diagnose a kind of germ cell line tumor. However, the tumor was diagnosed afterwards as a pure embryonal carcinoma. Three courses of PE chemotherapy followed by 30 Gy of whole craniospinal irradiation and 30 Gy of extended local irradiation were completed. An MRI showed the tumor to be in complete remission. Despite careful follow-up with chemotherapy every three months, a re-operation and linac radio-surgery, the tumor recurred, and disseminated. The patient died due to an intra-tumoral hemorrhage. A pure primary pineal embryonal carcinoma occurring in a middle-aged person has never been reported previously in detail.
本文报告一例发生于中年男性的原发性松果体胚胎癌病例。一名42岁男性因头痛和恶心被转诊至我科。神经系统检查发现他有帕里诺德征。头部CT和MRI显示松果体区有肿瘤。采用枕下经小脑幕入路对其进行手术。肿瘤部分切除，术中标本被用于诊断一种生殖细胞系肿瘤。然而，该肿瘤后来被诊断为纯胚胎癌。完成了三个疗程的PE化疗，随后进行30 Gy的全颅脊髓照射和30 Gy的扩大局部照射。MRI显示肿瘤完全缓解。尽管每三个月进行一次化疗、再次手术和直线加速器放射外科的密切随访，但肿瘤仍复发并扩散。患者因肿瘤内出血死亡。此前从未有过关于中年患者发生纯原发性松果体胚胎癌的详细报道。
