Ide M, Jimbo M, Yamamoto M, Hagiwara S, Aiba M, Kubo O
Department of Neurosurgery, Tokyo Women's Medical College Dai-ni Hospital, Japan.
Cancer. 1997 Feb 1;79(3):558-63. doi: 10.1002/(sici)1097-0142(19970201)79:3<558::aid-cncr19>3.0.co;2-2.
Testicular seminomas are well known to regress spontaneously at a higher incidence than other tumors. To date, there have been no reports of spontaneous regression of an intracranial germinoma, although these tumors are histologically identical to testicular seminomas.
The authors present a patient with a primary intracranial germinoma that regressed spontaneously.
A 21-year-old man was admitted to the study facility with acute onset of headache and vomiting. He had a 3-year history of polydipsia and polyuria. Computed tomography (CT) demonstrated a large tumor in the third ventricle, accompanied by hydrocephalus. He underwent ventriculoperitoneal shunt placement on the second day of hospitalization. A CT scan obtained on the fifth postoperative day demonstrated a remarkable decrease in tumor size. Because serial magnetic resonance imaging (MRI) demonstrated a gradual decrease in tumor size, tumor resection was not performed at that time. The patient was discharged and followed with MRI. The tumor continued to regress for more than 2 months. The patient was readmitted due to tumor regrowth, confirmed by MRI 4 months after the initial admission, despite the absence of symptom exacerbation. Two weeks later, the suprasellar portion of the tumor was resected through a right frontotemporal craniotomy. The histopathologic diagnosis was a germinoma. No concurrent tumors were found on whole body examination. The residual tumor gradually regressed after conventional radiation therapy and there has been neither tumor recurrence nor metastasis to date.
Although the precise cause of the transient partial regression is unknown, this case indicates that, like their testicular counterparts, intracranial germinomas may on occasion spontaneously regress.
睾丸精原细胞瘤以比其他肿瘤更高的发生率自发消退而闻名。迄今为止，尽管颅内生殖细胞瘤在组织学上与睾丸精原细胞瘤相同，但尚无颅内生殖细胞瘤自发消退的报道。
作者报告了一例原发性颅内生殖细胞瘤自发消退的患者。
一名21岁男性因急性头痛和呕吐入住研究机构。他有3年的烦渴和多尿病史。计算机断层扫描（CT）显示第三脑室内有一个大肿瘤，并伴有脑积水。他在住院第二天接受了脑室腹腔分流术。术后第5天的CT扫描显示肿瘤大小显著减小。由于连续磁共振成像（MRI）显示肿瘤大小逐渐减小，当时未进行肿瘤切除。患者出院并接受MRI随访。肿瘤持续消退超过2个月。尽管症状没有加重，但患者在初次入院4个月后因肿瘤复发再次入院，MRI证实了这一点。两周后，通过右额颞开颅手术切除了肿瘤的鞍上部分。组织病理学诊断为生殖细胞瘤。全身检查未发现并发肿瘤。残余肿瘤在常规放疗后逐渐消退，迄今为止既没有肿瘤复发也没有转移。
尽管短暂部分消退的确切原因尚不清楚，但该病例表明，与睾丸生殖细胞瘤一样，颅内生殖细胞瘤有时可能会自发消退。
