颅内生殖细胞瘤33例临床分析  

Intracranial germinoma:a clinical analysis of 33 cases

作　　者：赵向飞[1] 康静波[1] 聂青[1] 张军[1] 贾海威[1] 

机构地区：[1]海军总医院放射肿瘤科,北京100048

出　　处：《军事医学》2012年第7期539-542,共4页Military Medical Sciences

摘　　要：目的了解颅内生殖细胞瘤患者一般情况、临床表现、辅助检查和治疗的特点。方法对2000年1月至2011年1月海军总医院放射肿瘤科收治的33例颅内生殖细胞瘤进行回顾性分析。结果 33例患者中,男26例,女7例;发病部位:单发18例,多发15例;鞍区12例(36.4%),松果体区13例(39.4%),基底节区5例(15.2%),脑室9例。临床表现:颅内高压症状21例(63.7%)、视力下降及视野缺损10例(30.3%)、尿崩症11例(33.3%)、肢体无力7例(21.2%)。影像学检查:MRI显示长T1长T2或等T1等T2异常信号影,多数病变增强后明显强化。诊断方法:经病理诊断确诊17例,经诊断性放疗确诊16例。治疗:3例行肿瘤部分或全部切除术;4例合并梗阻性脑积水,行脑室分流术,10例行立体定向手术,患者均行放疗联合化疗,症状均有不同程度缓解,2例出现脊髓转移。结论颅压增高、多尿、复视是颅内生殖细胞瘤最常见的临床症状,病变常见位置为鞍区和松果体区,通过全脑+局部放疗联合化疗的治疗方式能使大部分患者病变缩小和临床症状缓解,获得长时间的生存。Objective To analyze the characteristics of clinical symptoms, examinations, and treatments in patients with intracranial germinoma. Methods Medical records of 33 cases with intracranial germinoma between January 2000 and January 2011 were retrospectively reviewed. Results The study population consisted of 26 males and 7 females. Eighteen patients had a single tumor and 15 patients had multiple tumor. Twelve（36.4% ） were in the sellar region, 13 （39.4%） in the pineal region, 5 cases（ 15.2% ） in basal ganglia and 9 cases in the periventricular region. Clinical manifestations： 21 patients （63.7%）had headache, nausea and vomiting; 10 （30.3%） had blurred vision and visual field damage; 11 （33. 3% ） patients had diabetes insipidus and 7 patients （21.2%） had limb weakness. Image study： MRI examination showed long T1, T2 or abnormal T1, T2 in MRI,which were enhanced equally by contrast medium. Diagnostic methods： 17 cases were confirmed by pathological diagnosis and 16 cases by diagnostic radiotherapy. Treatment： 3 cases underwent resection; 4 cases with obstructive hydrocephalus underwent ventriculoperitoneal shunt, and 10 patients underwent stereotactic surgery. All the patients underwent radiotherapy combined with chemotherapy. Symptoms were relieved obviously, but 2 patients had spinal cord metastasis. Conclusion The increased intracranial pressure, polyuria, diplopia are the most common clinical symptoms of intracranial germ cell tumors. Common locations of lesions are the saddle area and pineal region. The whole brain ＋ local radiotherapy combined with chemotherapy treatment is a common and effective modality for intracranial germinoma. Most patients have clinical symptoms remission and long survival.

关 键 词：颅内生殖细胞瘤 放射疗法 化学疗法 

分 类 号：R739.41[医药卫生—肿瘤]