Huang Jason H, Tsui Irena, Judkins Alexander R, Simon Erin, Birknes John K, Sutton Leslie N
Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Neurosurgery. 2004 Dec;55(6):1432.
We report an extremely rare case of primary intramedullary germinoma in the cervical spinal cord arising in an 18-year-old man who had not undergone previous surgery or irradiation.
The patient had a 2-month history of intermittent neck pain and a 4-week history of bilateral hand paresthesias and weakness. A magnetic resonance imaging scan demonstrated a heterogeneous cervical spine lesion with marked contrast enhancement extending from C3 to C6.
The patient underwent a cervical laminotomy with tumor resection, and pathological examination revealed the tumor to be a germinoma. He recovered well from the surgery with minimal neurological deficits. A postoperative magnetic resonance imaging scan of the brain and spinal cord did not show any other tumors. In addition, imaging studies of the mediastinum, testes, and the rest of the body also did not demonstrate any other tumors. The patient received local radiation as well as three courses of chemotherapy.
To our knowledge, this is the first report of an intramedullary cervical spine germinoma with confirmed tissue diagnosis. Although extremely uncommon, the possibility of germinoma should be included in the differential diagnosis for primary intramedullary spinal cord tumors.
我们报告一例极为罕见的原发性颈髓髓内生殖细胞瘤病例，患者为一名18岁男性，此前未接受过手术或放疗。
患者有2个月间歇性颈部疼痛病史，4周双侧手部感觉异常和无力病史。磁共振成像扫描显示颈椎有一不均匀病变，从C3至C6有明显的对比增强。
患者接受了颈椎板切开术及肿瘤切除术，病理检查显示肿瘤为生殖细胞瘤。他术后恢复良好，神经功能缺损极小。术后脑部和脊髓的磁共振成像扫描未显示任何其他肿瘤。此外，纵隔、睾丸及身体其他部位的影像学检查也未发现任何其他肿瘤。患者接受了局部放疗及三个疗程的化疗。
据我们所知，这是首例经组织学确诊的颈髓髓内生殖细胞瘤报告。尽管极为罕见，但生殖细胞瘤仍应纳入原发性脊髓髓内肿瘤的鉴别诊断。
