原发性颅内绒毛膜癌四例并文献复习  

Primary intracranial choriocarcinoma （four cases report and literatures review ）

作　　者：李海龙[1] 齐巍[1] 甲戈[1] 张玉琪[1] 马振宇[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科中心,北京市神经外科研究所,100050

出　　处：《中华神经外科杂志》2012年第10期987-990,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨原发性松果体区绒毛膜癌的临床特点、诊断、治疗方法及预后。方法回顾性分析北京天坛医院神经外科2002年5月至2010年5月收治的4例原发性松果体区绒毛膜癌患者的临床资料，复习相关文献，并对患者随访。结果4例患者均为男性，平均年龄13．75岁，病变均位于松果体区，平均直径4～5cm。3例术前行诊断性放疗，其中2例出现肿瘤卒中。采用经胼胝体一穹隆间入路切除肿瘤，其中全切3例，近全切除1例，术后均建议化疗。随访时间1个月一5年，3例死亡，1例存活，随访期内平均生存时间为31．7个月。结论原发性松果体区绒毛膜癌极为罕见，预后极差。血清或脑脊液人绒毛膜促性腺激素（13-HCG）明显升高有助于诊断。手术切除联合化疗是常规治疗方法，放疗因增加出血风险，瘤体较大时，不建议作为常规辅助治疗。Objective To investigate the clinical features, diagnosis, therapeutic strategy and prognosis of Primary Intracrauial Choriocarcinoma （PICCC）. Methods A retrospective review of four patients with PICCC diagnosed histopathologically was performed during May 2002 to May 2010, and all patients were followed up and pertinent literatures were reviewed. Results There were four young male children studied. The average age of all patients was 13.75 years. Everyone had a mass lesion in pineal region where its average diameter was 4 ~ 5 cm. Three cases were given preoperative diagnostic irradiation, of which two cases had hemorrhage after irradiation. All received operation with trans - corpuscallosum - fornix approach, three cases received total resection, and the other one had subtotal resection. After operation, all cases were supposed to have chemotherapy. 3 patients died finally during a follow - up period range from 1 month to 5 years with chemotherapy, and the mean survival time was 31.7 months. Conclusions PICCC are extremely rare and the most malignant of primary intracranial GCTs, patients have poor prognosis. Markedly elevated 13-HCG levels in serum or cerebrospinal fluid are strongly suggested to be found with PICCC while mild elevations can be seen with other GCTs. The authors recommend surgery for patients with PICCC combined with chemotherapy. Radiotherapy is not the conventional therapy due to the increasing risk of hemorrhage.

关 键 词：绒毛膜癌 肿瘤 生殖细胞和胚胎性 诊断 化学疗法 外科手术 

分 类 号：R739.41[医药卫生—肿瘤]