Yoshizawa H, Matsutani M, Miyoshi A, Nagashima C
Department of Neurosurgery, Saitama Medical School, Japan.
No Shinkei Geka. 1995 Jun;23(6):549-53.
We report a case of a patient with recurrent malignant germ cell tumor who was successfully treated with carboplatin combination followed by radiation therapy. A 13 year-old female presented with diabetes insipidus six years ago. From the homogeneous tumor intensity on CT scan and negative titer of AFP and HCG, we made a diagnosis of suprasellar germinoma, and treated her with radiation therapy (40Gy), which resulted in almost complete disappearance of the tumor. The tumor recurred six years later in the primary region and in the cervical spinal cord with elevated AFP titer (160ng/ml) and HCG titer (404mlU/ml). She was treated with multi-agents chemotherapy consisting of carboplatin (450mg/m2, day 1), etoposide (150mg/m2, days 1-3), adriamycin (30mg/m2, day 1), and bleomycin (20mg/m2, days 1 and 8), followed by radiation therapy to the whole brain (20Gy), the whole spine (30Gy) and the cervical spine (20Gy). The tumors completely disappeared. We discuss treatment failures of clinically diagnosed germinoma without histological verification, and effective aggressive chemotherapy for recurrent malignant germ cell tumors.
我们报告一例复发性恶性生殖细胞肿瘤患者，该患者接受卡铂联合放疗后成功治愈。一名13岁女性6年前出现尿崩症。根据CT扫描上肿瘤密度均匀以及甲胎蛋白（AFP）和人绒毛膜促性腺激素（HCG）滴度阴性，我们诊断为鞍上生殖细胞瘤，并对她进行了放疗（40Gy），肿瘤几乎完全消失。6年后肿瘤在原发部位和颈髓复发，AFP滴度升高（160ng/ml），HCG滴度升高（404mlU/ml）。她接受了多药联合化疗，包括卡铂（450mg/m²，第1天）、依托泊苷（150mg/m²，第1 - 3天）、阿霉素（30mg/m²，第1天）和博来霉素（20mg/m²，第1天和第8天），随后对全脑（20Gy）、全脊柱（30Gy）和颈椎（20Gy）进行放疗。肿瘤完全消失。我们讨论了未经组织学证实的临床诊断生殖细胞瘤的治疗失败情况，以及复发性恶性生殖细胞肿瘤有效的积极化疗方法。
