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| 題 名 | Mixed Germ Cell Tumor Presenting as Intratumoral Hemorrhage: Report of a Case Originated from the Pineal Region=以腫瘤內出血表現之松果體混合型生殖細胞瘤 |
|---|---|
| 作 者 | 洪裕昌; 李宜堅; 王亮超; 陳幸鴻; 顏經洲; 俞芹英; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
| 卷 期 | 15:8 1999.08[民88.08] |
| 頁 次 | 頁498-503 |
| 分類號 | 416.291 |
| 關鍵詞 | 腫瘤內出血; 松果體; 生殖細胞瘤; Pineal tumor; Hemorrhage; |
| 語 文 | 英文(English) |
| 中文摘要 | 一位十七歲的男性病人在劇烈運動後發生突發性頭痛,嘔吐及暫時性意識喪失而被送至本院。神經學檢查顯示病人有嚴重的感覺運動及腦幹功能障礙。頭部電腦斷層掃描及核磁共振造影發現在松果體附近有一個不同顯影密度的巨大腫瘤併發出血。腫瘤指標在甲型胎兒蛋白(AFP)呈現上升,而人類絨毛膜性腺促進激素(HCG)及癌胚抗原(CEA)則正常。在臨床上高度懷疑為一松果體混合型生殖細胞瘤。在計畫性的緊急放射治療之前,病人接受開顱組織採檢,由於術後併發血腫,不得不導致另一治療方式:腫瘤及小腦血塊的完全清除。病理組織報告證實為一混合型生殖細胞瘤併腫瘤內出血。在松果體的生殖細胞瘤併發自發性出血是相當罕見的,可能是腫瘤內靜脈循環受損所導致。造成病人小腦血塊的這種出血傾向,是我們在做組織採檢時所必需特別注意的。 |
| 英文摘要 | A 17-year-old male patient was brought to our clinic because of sudden onset of headache, vomiting, followed by transient loss of consciousness during a strenuous exercise. Neurologic examinations reveled that the patient had severe sensorimotor and brain stem dysfunction. Examinations of cranial CT and MR imaging showed a huge heterogeneously enhanced tumor originated from the pineal region with tumoral hemorrhage. The tumor markers were found to be high in AFP but not the β-HCG and CEA. A clinical diagnosis highly suggestive of germ cell tumor was made. Prior to the planned emergency radiation therapy, he received an eternal ventricular drainage (EVD) and open biopsy of the tumor. Due to a postoperative complication of cerebellar hemorrhage observed 8 hours later, another maneuver was therefore required to extirpate the pineal tumor and cerebellar hematoma. The histological diganosis proved to be a mixed germ cell tumor with tumoral hemorrhage. Spontaneous intratumoral hemorrhage in germ cell tumor of the pineal region is rare, probably due to compromised venous circulation within the tumor. The bleeding propensity, which may contributed to the formation of cerebellar hematoma, warrants a special attention when a biopsy procedure is to be performed. |
本系統中英文摘要資訊取自各篇刊載內容。