成人松果体周围以卵黄囊瘤为主的混合性生殖细胞肿瘤：病例报告及文献复习。
Adult-Onset Mixed Germ Cell Tumor Composed Mainly of Yolk Sac Tumor Around the Pineal Gland: A Case Report and Review of the Literature.
机构信息
Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
World Neurosurg. 2019 Dec;132:87-92. doi: 10.1016/j.wneu.2019.08.079. Epub 2019 Aug 27.
BACKGROUND
Mixed germ cell tumors (MGCTs) usually occur in children. In the present report, we discuss an extremely rare case of adult-onset MGCT composed mainly of yolk sac tumor (YST) around the pineal gland.
CASE DESCRIPTION
A 54-year-old Japanese man presented with disturbance of consciousness, Parinaud's syndrome, and gait disturbance. Magnetic resonance imaging revealed a pineal mass lesion, and subtotal resection of the tumor was achieved. The histologic diagnosis was MGCT, consisting mainly of YST. Although he underwent 5 courses of chemotherapy and craniospinal irradiation after surgery, tumor dissemination could not be controlled, and he died 10 months postoperatively.
CONCLUSION
The present case highlights the need for clinicians to include YST in the differential diagnosis of acute progressive lesions around the pineal region, even in adult patients.
背景
混合性生殖细胞瘤（MGCT）通常发生于儿童。在本报告中，我们讨论了一例极为罕见的成人松果体周围 MGCT 病例，其主要由卵黄囊瘤（YST）组成。
病例描述
一名 54 岁日本男性因意识障碍、帕里诺氏综合征和步态障碍就诊。磁共振成像显示松果体肿块病变，行肿瘤次全切除术。组织学诊断为 MGCT，主要由 YST 组成。尽管他在手术后接受了 5 个疗程的化疗和全脑脊髓照射，但肿瘤仍无法控制扩散，术后 10 个月死亡。
结论
本病例强调了临床医生需要将 YST 纳入松果体周围急性进行性病变的鉴别诊断，即使是在成年患者中。
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