Yang Yi, Ren Zu-yuan, Su Chang-bao, Wang Ren-zhi, Ma Wen-bin
Department of Neurosurgery, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2003 Jun;25(3):350-3.
That eleven patients with sellar germinomas were confirmed by pathological examinations were retrospectively reviewed. In the 11 patients, 2 were males and 9 were females. Mean age was 16.8 years old and mean history was 2.6 years. Among them, 11 patients had diabetes insipidus, 6 patients had visual disturbances, 5 patients had retarded growth, and 5 patients had hypopituitary function. The diameter of tumor was 1-3 cm in 8 cases and greater than 3 cm in 3 cases. MRI showed hypointensity or homogeneous on T1-weighted images in 8 cases. The tumors were fibrous, purple grey or reddish in color with rich blood supply. Germinomas were confirmed by postoperative pathological examinations. All patients received postoperative irradiation. Postoperative follow-up was from 3 months to 6 years. Diabetes insipidus was improved in 9 cases. Visual function were improved in 4 cases, but hypopituitarism and retarded growth were unchanged. In conclusion, when MRI shows sellar parenchyma tumor with unclear boundary in young patients with diabetes insipidus and hypopituitarism, sellar germinoma should be highly suspected. Otherwise, radiation therapy may profitably aid to confirm the diagnosis since irradiation is the main treatment of sellar germinomas.
回顾性分析11例经病理检查确诊的鞍区生殖细胞瘤患者。11例患者中,男性2例,女性9例。平均年龄16.8岁,平均病程2.6年。其中,11例患者有尿崩症,6例有视力障碍,5例生长发育迟缓,5例有垂体功能减退。肿瘤直径1 - 3 cm者8例,大于3 cm者3例。8例MRI在T1加权像上呈低信号或等信号。肿瘤质地坚韧,呈紫灰色或红色,血供丰富。术后病理检查确诊为生殖细胞瘤。所有患者术后均接受放疗。术后随访3个月至6年。9例尿崩症有所改善。4例视力功能改善,但垂体功能减退和生长发育迟缓无变化。总之,年轻患者出现尿崩症和垂体功能减退,MRI显示鞍区实质肿瘤边界不清时,应高度怀疑鞍区生殖细胞瘤。否则,放疗可能有助于确诊,因为放疗是鞍区生殖细胞瘤的主要治疗方法。