Kamitani Hideki, Miyata Hajime, Ishibashi Minako, Kurosaki Masamichi, Mizushima Minoru, Akatsuka Keiichi, Ohama Eisaku, Watanabe Takashi
Department of Neurosurgery, Tottori University, Yonago, 683-8504, Japan.
Brain Tumor Pathol. 2006 Oct;23(2):83-9. doi: 10.1007/s10014-006-0205-x.
We report a case of intracranial germ cell tumor that showed pathological changes from neurohypophyseal germinoma to mixed germ cell tumors consisting exclusively of undifferentiated sarcomatous component after radiochemotherapy. Three surgical specimens and autopsied brain from the patient were histologically examined. An initial specimen from the neurohypophyseal tumor was diagnosed as germinoma with a two-cell pattern. Five years later, after repeated radiochemotherapy, the second specimen resected from the right temporal lobe showed mixed germ cell tumors consisting of the three components of germinoma, choriocarcinoma, and immature teratoma. Six months later after intensive radiotherapy, the right temporal tumor recurred and was surgically removed. The histological diagnosis was mixed germ cell tumors with abundant immature teratoma component. The patient died of uncontrollable tumor growth with repeated intratumoral hemorrhages. The autopsied brain showed sarcoma with angionecrosis. This pathological alteration indicated an increase in the sarcomatous component after undergoing various treatments. We discuss the histological changes of intracranial germ cell tumor modified by treatment.
我们报告一例颅内生殖细胞肿瘤病例，该病例在放化疗后显示出从神经垂体生殖细胞瘤到仅由未分化肉瘤成分组成的混合性生殖细胞肿瘤的病理变化。对该患者的三个手术标本和尸检大脑进行了组织学检查。神经垂体肿瘤的初始标本被诊断为具有双细胞模式的生殖细胞瘤。五年后，在反复放化疗后，从右颞叶切除的第二个标本显示为混合性生殖细胞肿瘤，由生殖细胞瘤、绒毛膜癌和未成熟畸胎瘤三种成分组成。强化放疗六个月后，右颞叶肿瘤复发并接受手术切除。组织学诊断为具有丰富未成熟畸胎瘤成分的混合性生殖细胞肿瘤。患者死于无法控制的肿瘤生长并伴有反复的肿瘤内出血。尸检大脑显示为伴有血管坏死的肉瘤。这种病理改变表明经过各种治疗后肉瘤成分增加。我们讨论了经治疗后颅内生殖细胞肿瘤的组织学变化。
