Lin C L, Loh J K, Howng S L
Department of Neurosurgery, Kaohsiung Medical College, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1997 Jul;13(7):462-6.
A 15-year-old male was admitted to our hospital with diabetes insipidus, headache and bitemporal hemianopia and a computed tomogram (CT) revealed an intra- and suprasellar tumor. Differential diagnosis between large intra- and suprasellar germinoma and pituitary adenomas is quite difficult based on CT. After comparing our case with past literature of reported cases of intrasellar and suprasellar germinoma, we found that an enhanced mass posterior to the pituitary gland on the midsagittal magnetic resonance imaging (MRI) and absence of the high signal intensity of the posterior lobe on T1-weighted MRI in patients with diabetes insipidus indicated germinoma rather than a pituitary adenoma. Transphenoid approach and appropriate radiotherapeutic management were administered with a good result.
一名15岁男性因尿崩症、头痛和双颞侧偏盲入院，计算机断层扫描（CT）显示鞍内及鞍上有肿瘤。基于CT鉴别鞍内及鞍上大型生殖细胞瘤和垂体腺瘤相当困难。将我们的病例与既往鞍内及鞍上生殖细胞瘤报告病例的文献进行比较后，我们发现，矢状位磁共振成像（MRI）上垂体后方强化肿块以及尿崩症患者T1加权MRI上垂体后叶无高信号强度提示为生殖细胞瘤而非垂体腺瘤。采用经蝶窦入路并进行了适当的放射治疗，效果良好。
