Tsukamoto H, Matsushima T, Shono S, Miyazono M, Fukui M, Kondo A
Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Surg Neurol. 1992 Jul;38(1):50-6. doi: 10.1016/0090-3019(92)90212-6.
A rare case of yolk sac tumor in the cerebellar vermis is reported. A 2-year-old boy developed headaches, vomiting, and an unsteady gait. Later a tumor was demonstrated in the medial part of the cerebellum by gadolinium-enhanced magnetic resonance imaging (MRI). The tumor was totally removed, and the surgery was followed by chemotherapy. Soon after surgery the elevated alphafetoprotein (AFP) levels in the serum and cerebrospinal fluid were observed to decrease to normal levels. Three months later enhanced MRI showed a lesion in the vermis without any elevation of AFP, and the lesion turned out to be a granuloma. Six months after the second surgery a tumor recurred that could not be totally removed. Cranial radiotherapy was given together with chemotherapy, which resulted in a decrease of AFP to the normal range. The patient is doing well without any elevation in AFP at 1 year 6 months after onset. Related problems in the diagnosis and treatment of yolk sac tumors are discussed.
报告了一例罕见的小脑蚓部卵黄囊瘤病例。一名2岁男孩出现头痛、呕吐和步态不稳。后来，钆增强磁共振成像（MRI）显示小脑中部有一个肿瘤。肿瘤被完全切除，术后进行了化疗。术后不久，观察到血清和脑脊液中升高的甲胎蛋白（AFP）水平降至正常水平。三个月后，增强MRI显示蚓部有一个病变，AFP没有任何升高，该病变原来是一个肉芽肿。第二次手术后六个月，肿瘤复发，无法完全切除。同时进行了头颅放疗和化疗，导致AFP降至正常范围。发病后1年6个月，患者情况良好，AFP没有任何升高。讨论了卵黄囊瘤诊断和治疗中的相关问题。
