Steimle R, Raffi A, Bonneville J F, Carbillet J P, Schraub S, Jacquet G, Abdul-Razzak A
Neurochirurgie. 1979;25(2):129-33.
The now nine years old girl with growth retardation, started to be ill with otitis and then diabetes insipidus of central origin at 1974. A treatment with lysin-vasopressin is prescribed. The PNEG in May 1976 shows a little, pea like, suspicious, supra-sellar nodule who is not surgically explored since they was no ophtalmologic symptoms and because a normal CT scan. Corticoid and thyroid substitutive therapy is added until September 1977 when the general status becomes impaired and vomiting starts. Also because some visual loss, a new neuroradiological study is performed showing a supra-sellar tumour and a fourth ventricle mass. The CT scan asserts the double intracranial expansive process and a posterior fossa craniotomy is done with subtotal resection of a vermian tumour and Torkildsen drainage. The histology is : Immature Dysembryoma (seminoma type) or germinoma. The follow-up was good under hormonal care. X Rays Therapy over the posterior fossa, the suprasellar region, the brain and the spinal channel was instaured. Four months later, the CT scan shows normal sized ventricles and no tumour mass at all. This case gives the authors opportunity for comments and to study the concerned literature.
这个现已9岁的女孩生长发育迟缓，1974年开始患中耳炎，随后患上中枢性尿崩症。开始使用赖氨酸加压素进行治疗。1976年5月的蝶鞍上区正电子发射断层扫描（PNEG）显示有一个豌豆大小的可疑小结节，由于没有眼科症状且CT扫描正常，未对其进行手术探查。添加了皮质类固醇和甲状腺替代疗法，直到1977年9月，患儿一般状况变差并开始呕吐。又因出现一些视力丧失，于是进行了一项新的神经放射学检查，结果显示蝶鞍上有肿瘤以及第四脑室有肿块。CT扫描证实了颅内的双重占位性病变，遂进行后颅窝开颅手术，次全切除蚓部肿瘤并进行了托氏引流术。组织学检查结果为：未成熟胚胎瘤（精原细胞瘤型）或生殖细胞瘤。在激素治疗下随访情况良好。对后颅窝、蝶鞍上区、脑部和脊髓通道进行了X线放射治疗。四个月后，CT扫描显示脑室大小正常，完全没有肿瘤肿块。该病例为作者提供了发表评论和研究相关文献的机会。
