Ishikura A, Hunaki N, Watanabe K
Dept. of Neurosurgery, Kanazawa National Hospital.
Gan No Rinsho. 1987 Nov;33(14):1815-9.
A 22-year-old woman with a history of headaches and secondary amenorrhea is reported. Her physical examination showed a visual acuity loss. An endocrine evaluation revealed hypopituitarism and an elevated level of serum prolactin. Polytomography demonstrated an enlarged sella with a double floor. A computerized tomography (CT) scan revealed an enhancing lesion within the sella turcica with an extension into the suprasellar cistern. A lumbar puncture was performed and the cerebrospinal fluid was found to contain no tumor cells. The patient subsequently underwent a trassphenoidal exploration of the sella and an intrasellar tumor removal. A histological analysis of the surgical specimen revealed a germinoma. A total dose of 3500 rads with lineac was applied to the whole brain postoperatively. Her vision is now normal. The pathogenesis of an intracranial germinoma is briefly discussed, and a review of the literature discloses 48 previous reports of germinoma.
报告了一名22岁有头痛和继发性闭经病史的女性。她的体格检查显示视力丧失。内分泌评估显示垂体功能减退和血清催乳素水平升高。多层面体层摄影显示蝶鞍增大,有双层底部。计算机断层扫描(CT)显示蝶鞍内有一个强化病变,并延伸至鞍上池。进行了腰椎穿刺,发现脑脊液中没有肿瘤细胞。患者随后接受了蝶鞍经蝶窦探查和鞍内肿瘤切除术。手术标本的组织学分析显示为生殖细胞瘤。术后对全脑应用了3500拉德的直线加速器总剂量。她现在视力正常。简要讨论了颅内生殖细胞瘤的发病机制,文献回顾揭示了之前48例生殖细胞瘤的报告。