Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam.
Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam,
Pediatr Neurosurg. 2020;55(6):426-431. doi: 10.1159/000512345. Epub 2020 Dec 22.
Extragonadal germinomas rarely emerge from the brain stem; however, proper diagnosis and treatment can result in favorable prognosis. Unfortunately, the preoperative diagnosis of medulla oblongata germinoma is difficult due to insufficient clinical signs and symptoms that are specific to this diagnosis. Case Representation: We present a 12-year-old male patient with an intra-fourth-ventricular germinoma, derived from the medulla oblongata, with no abnormalities in the supratentorial region. The germinoma was initially assessed by advance MRI sequences, including diffusion-weighted imaging, T1 perfusion, and spectroscopy.
In summary, although existing imaging technologies cannot completely distinguish germinomas from other primary brain neoplasms in the fourth ventricle, in patients aged between 12 and 40 years, a small mass on the dorsal side of medulla oblongata that emerges into the fourth ventricle and is characterized by homogeneous contrast enhancement, the absence of calcification and hemorrhage, and the lack of hydrocephalus should be considered for a potential medulla oblongata germinoma diagnosis.
颅内生殖细胞瘤很少从脑干中出现；然而，正确的诊断和治疗可以带来良好的预后。不幸的是，由于缺乏针对该诊断的特异性临床表现，脑干生殖细胞瘤的术前诊断较为困难。病例报告：我们呈现了一例 12 岁男性患者，其第四脑室的生殖细胞瘤起源于延髓，而幕上区域无异常。生殖细胞瘤最初通过包括弥散加权成像、T1 灌注和波谱在内的先进 MRI 序列进行评估。
总之，尽管现有成像技术无法完全区分第四脑室中的生殖细胞瘤与其他原发性脑肿瘤，但在 12 至 40 岁的患者中，如果第四脑室背侧出现小的肿块，向第四脑室突出，表现为均匀对比增强、无钙化和出血，并且没有脑积水，应考虑可能为延髓生殖细胞瘤。
