Uchino Masafumi, Haga Daisuke, Mito Toshiaki, Kuramitsu Tohru, Nakamura Noriko
Department of Neurosurgery, Saiseikai Yokohama-shi Nambu Hospital, Yokohama-shi, Kanagawa-ken, Japan.
J Neurooncol. 2006 Sep;79(3):255-8. doi: 10.1007/s11060-006-9138-9. Epub 2006 Mar 24.
Intracranial germinoma arising primarily in the midbrain is extremely rare. We present the first reported case of cystic midbrain germinoma that lacked evident solid components and mimicked a midbrain glioma. In a 22-year-old man with headache and diplopia, magnetic resonance imaging showed a ring-enhancing lesion in the midbrain. The preoperative diagnosis included brain stem glioma, metastasis, and neuroepithelial cyst. A neuroendoscopic biopsy specimen provided a histologic diagnosis of germinoma. The patient responded well to chemotherapy and radiotherapy. The case illustrates the diagnostic value of neuroendoscopic biopsy in the differential diagnosis of brainstem lesions in adult. The possibilities considered should now include germinoma.
主要起源于中脑的颅内生殖细胞瘤极为罕见。我们报告了首例囊性中脑生殖细胞瘤，该肿瘤缺乏明显的实性成分，类似中脑胶质瘤。一名22岁男性，有头痛和复视症状，磁共振成像显示中脑有一个环形强化病灶。术前诊断包括脑干胶质瘤、转移瘤和神经上皮囊肿。神经内镜活检标本提供了生殖细胞瘤的组织学诊断。该患者对化疗和放疗反应良好。该病例说明了神经内镜活检在成人脑干病变鉴别诊断中的诊断价值。现在应考虑的可能性包括生殖细胞瘤。
