Bilateral metachronous germinoma of the basal ganglia occurring long after total removal of a mature pineal teratoma: Case report
Bilateral metachronous germinoma of the basal ganglia occurring long after total removal of a mature pineal teratoma: Case report
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DOI：
10.1097/00006123-200203000-00033
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发表时间：
2002-03-01
期刊：
影响因子：
4.8
通讯作者：
Nishikawa, M
中科院分区：
文献类型：
--
作者：
Sugimoto, K;Nakahara, I;Nishikawa, M
目标和重要性：我们报告的第二生殖细胞肿瘤发生在不同的网站和不同的组织学类型后，长期完全删除的成熟松果体畸胎瘤。临床表现：一个10岁的男孩谁提出头痛和呕吐被收治到我们的医院。神经放射学检查显示松果体区有一个肿瘤。肿瘤被完全切除了。组织学上，肿瘤被证明是一个成熟的畸胎瘤。患者的术后病程顺利。患者未接受辅助治疗，并在门诊接受随访。三年后，他因短暂的左上肢无力和呕吐再次入院。神经放射学检查显示双侧基底节肿瘤。干预：第二个肿瘤，位于右侧基底节，部分切除活检。组织学检查证实为生殖细胞瘤。患者接受了三个周期的联合化疗，包括卡铂和依托泊苷与放疗。第二个疗程化疗后，磁共振成像研究显示没有证据的tumor.CONCLUSION：第二个肿瘤被认为是一个新的异时性肿瘤，而不是原来的成熟畸胎瘤复发。我们认为，如果脑中线存在沿着的原始生殖细胞群，两个以上的原始生殖细胞群可引起不同部位、不同组织学类型的异时性肿瘤。
OBJECTIVE AND IMPORTANCE: We report the extremely rare occurrence of a second germ cell tumor at a different site and with different histological types long after total removal of a mature pineal teratoma.CLINICAL PRESENTATION: A 10-year-old boy who presented with headache and vomiting was admitted to our hospital. Neuroradiological studies revealed a tumor in the pineal region. The tumor was totally removed. Histologically, the tumor proved to be a mature teratoma. The patient's postoperative course was uneventful. The patient received no adjuvant therapy and was followed in the outpatient clinic. Three years later, he was readmitted with transient left upper limb weakness and vomiting. Neuroradiological studies showed a tumor in the bilateral basal ganglia.INTERVENTION: The second tumor, which was located in the right basal ganglion, was partially removed for biopsy. Histologically, the tumor proved to be a germinoma. The patient received three cycles of combination chemotherapy consisting of carboplatin and etoposide with radiotherapy. After the second course of chemotherapy, magnetic resonance imaging studies revealed no evidence of the tumor.CONCLUSION: The second tumor was considered to be a de novo metachronous neoplasm rather than a recurrence of the original mature teratoma. We think that if primordial germ cell groups exist along the midline of the brain, more than two primordial germ cell groups could give rise to metachronous neoplasms at different sites and with different histological types.