Bjornsson J, Scheithauer B W, Okazaki H, Leech R W
J Neuropathol Exp Neurol. 1985 Jan;44(1):32-46.
Seventy cases of histologically verified intracranial germ cell tumor were reviewed: 43 germinomas, 16 immature teratomas, seven mature teratomas, two embryonal carcinomas, one choriocarcinoma, and one yolk sac tumor. The male-to-female ratio was 2.6:1. The average age was 19 years in patients with germinoma, 11 years in patients with immature teratoma, and 17 years in patients with mature teratoma. Duration of symptoms averaged 19 months for germinoma, three months for immature teratoma, and 11 months for mature teratoma. Sixty-six lesions were located in the midline. Fifty-eight percent of the germinomas arose anterior to the pineal gland, whereas 29% of the immature and 14% of the mature teratomas were located anteriorly. The histologic appearance of the germinomas was indistinguishable from that of the usual testicular seminoma. The immature teratomas contained tissue from all three germ layers and exhibited morphologic features of fetal tissue. Of 14 immature teratomas, seven contained, in addition, foci of other malignant germ cell elements; thus, there were two teratocarcinomas, two lesions with germinoma and immature teratoma, two lesions with extensive rhabdomyoblastic differentiation in an immature teratoma, and one lesion with both germinoma and embryonal carcinoma in addition to immature teratoma. The seven mature teratomas consisted of fully differentiated epithelial and mesenchymal tissues. In 23 cases, immunoperoxidase stains for human chorionic gonadotropin (HCG), alpha-fetoprotein (AFP), and carcino-embryonic antigen (CEA) revealed patterns which, with minor exceptions, were essentially identical to those found in genital germ cell lesions. Survival was longest for patients with germinomas. In classifying germ cell tumors of the central nervous system, the World Health Organization's (WHO) classification of testicular germ cell tumors is preferable to its present classification of intracranial germ cell tumors.
回顾了70例经组织学证实的颅内生殖细胞肿瘤病例：43例生殖细胞瘤、16例未成熟畸胎瘤、7例成熟畸胎瘤、2例胚胎癌、1例绒毛膜癌和1例卵黄囊瘤。男女比例为2.6:1。生殖细胞瘤患者的平均年龄为19岁，未成熟畸胎瘤患者为11岁，成熟畸胎瘤患者为17岁。生殖细胞瘤症状持续时间平均为19个月，未成熟畸胎瘤为3个月，成熟畸胎瘤为11个月。66个病灶位于中线。58%的生殖细胞瘤起源于松果体前方，而29%的未成熟畸胎瘤和14%的成熟畸胎瘤位于前方。生殖细胞瘤的组织学表现与常见的睾丸精原细胞瘤无法区分。未成熟畸胎瘤包含来自所有三个胚层的组织，并表现出胎儿组织的形态学特征。在14例未成熟畸胎瘤中，7例还含有其他恶性生殖细胞成分灶；因此，有2例畸胎癌、2例同时有生殖细胞瘤和未成熟畸胎瘤的病灶、2例未成熟畸胎瘤中有广泛横纹肌母细胞分化的病灶，以及1例除未成熟畸胎瘤外还有生殖细胞瘤和胚胎癌的病灶。7例成熟畸胎瘤由完全分化的上皮和间叶组织组成。在23例病例中，人绒毛膜促性腺激素（HCG）、甲胎蛋白（AFP）和癌胚抗原（CEA）的免疫过氧化物酶染色显示的模式，除少数例外，与生殖系统生殖细胞病变中发现的模式基本相同。生殖细胞瘤患者的生存期最长。在对中枢神经系统生殖细胞肿瘤进行分类时，世界卫生组织（WHO）对睾丸生殖细胞肿瘤的分类比其目前对颅内生殖细胞肿瘤的分类更可取。
