起源于岛叶的原发性生殖细胞瘤：一例报告并文献复习
Primary Germinoma Originating from the Insular Lobe: A Case Report and Review of the Literature.
作者信息
Luo Zhengxiang, Qian Zhongrun, Yang Kun, Liu Hongyi, Zhang Wenbin, Zeng Yanjun
机构信息
Department of Neurosurgery, NanJing Brain Hospital affiliated with NanJing Medical University, NanJing, China.
Department of Neurosurgery, NanJing Brain Hospital affiliated with NanJing Medical University, NanJing, China.
出版信息
World Neurosurg. 2017 Feb;98:871.e1-871.e7. doi: 10.1016/j.wneu.2016.12.004. Epub 2016 Dec 19.
BACKGROUND
Primary intracranial germinomas occurring in the cerebral hemisphere are extremely rare, with only a few reported cases in the literature. We describe an unusual case of a primary germinoma that developed in the insular lobe, with little involvement in the basal frontal lobe.
CASE DESCRIPTION
A 19-year-old man presented with headache and vomiting. Magnetic resonance imaging showed a solitary, ring-like enhanced lesion in the left hemisphere, and a preliminary diagnosis of glioma was made. Surgery was performed, and the diagnosis of germinoma was made based on the histopathologic results.
CONCLUSIONS
The causes of ectopic germinomas of the midline structures of the brain are still unclear, but the theory of misplacement may partially clarify this phenomenon. Reflecting a lack of definitive management guidelines for atypical germinoma, the present patient was treated with focal radiotherapy around the lesion after surgery and achieved remission by 34 months postoperatively.
背景
发生于大脑半球的原发性颅内生殖细胞瘤极为罕见，文献中仅有少数病例报道。我们描述了一例不寻常的原发性生殖细胞瘤，其发生于岛叶，基底额叶受累较少。
病例描述
一名19岁男性因头痛和呕吐就诊。磁共振成像显示左半球有一个孤立的环形强化病灶，初步诊断为胶质瘤。进行了手术，根据组织病理学结果诊断为生殖细胞瘤。
结论
脑中线结构异位生殖细胞瘤的病因仍不清楚，但错位理论可能部分解释这一现象。由于缺乏非典型生殖细胞瘤的明确管理指南，本例患者术后接受了病灶周围局部放疗，术后34个月病情缓解。
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