Han Lei, Lu Jie, Fang Luxiong, Qi Songtao, Song Ye
Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
J Neurosurg Case Lessons. 2021 Jan 18;1(3):CASE2067. doi: 10.3171/CASE2067.
Simultaneous intracranial and testicular germ cell tumors (GCTs) are extremely rare, leading to a lack of adequate experience in their treatment. Therefore, the authors report a case of this kind of GCT.
A 5-year-old boy was admitted to the hospital with headache and vomiting. Computed tomography and magnetic resonance imaging suggested the possibility of a GCT in the pineal region. The value of the serum tumor marker alpha-fetoprotein (AFP) was 5,396.1 μg/L, and β-human chorionic gonadotropin levels were within the normal range. Subsequently, the tumor was removed, and the final pathological result was a mixed GCT. Therefore, chemotherapy and radiation were added. However, the authors found a testicular tumor on ultrasound at the same time, and pathology after surgery suggested a mature cystic teratoma. Following treatment, the patient recovered well, and AFP levels dropped to normal values.
To the authors' knowledge, this report is the fourth case of simultaneous intracranial and testicular GCTs and the first case of a simultaneous mixed GCT in the pineal region and mature teratoma of the testis. A combination of surgery, chemotherapy, and radiation therapy for mixed GCTs in the pineal region and surgical excision for testicular reproductive cell tumors are effective in these patients, but long-term monitoring is required.
颅内和睾丸同时发生生殖细胞肿瘤（GCTs）极为罕见，导致在其治疗方面缺乏足够的经验。因此，作者报告了一例此类GCT。
一名5岁男孩因头痛和呕吐入院。计算机断层扫描和磁共振成像提示松果体区可能存在GCT。血清肿瘤标志物甲胎蛋白（AFP）值为5396.1μg/L，β-人绒毛膜促性腺激素水平在正常范围内。随后，肿瘤被切除，最终病理结果为混合性GCT。因此，增加了化疗和放疗。然而，作者同时在超声检查中发现了睾丸肿瘤，术后病理提示为成熟囊性畸胎瘤。经过治疗，患者恢复良好，AFP水平降至正常。
据作者所知，本报告是第四例颅内和睾丸同时发生GCT的病例，也是第一例松果体区同时发生混合性GCT和睾丸成熟畸胎瘤的病例。对于松果体区混合性GCT采用手术、化疗和放疗相结合，以及对睾丸生殖细胞肿瘤进行手术切除，对这些患者有效，但需要长期监测。
