鞍区生殖细胞瘤合并妊娠病例报告并文献综述

A Case of Pregnancy with Suprasellar Germinoma Diagnosed and Review of the Literature

目的分析妊娠合并鞍区生殖细胞瘤的关系,并探讨鞍区生殖细胞瘤的影像特征。方法对1例鞍区生殖细胞瘤孕妇患者行MRI检查误诊为垂体大腺瘤,结合病理及免疫组化诊断为鞍区生殖细胞瘤,总结鞍区生殖细胞瘤的影像诊断特点,并与鞍区其它肿瘤(垂体大腺瘤、脑膜瘤)进行对比研究,并对妊娠合并生殖细胞瘤相关文献回顾分析。结果本例鞍区生殖细胞瘤发生于孕37周的孕妇,MRI影像于垂体窝内见一等T1稍长T2软组织信号肿块,增强肿块明显不均匀强化,病灶突向鞍上池,双侧海绵窦受压,蝶鞍扩大。患者急诊行剖宫产术,3天后急诊全麻下行内镜经鼻蝶肿瘤切除术,标本行病理及免疫组化检查,诊断为鞍区生殖细胞瘤。结论妊娠合并鞍区生殖细胞瘤非常罕见,其影像表现容易误诊为垂体大腺瘤及脑膜瘤,需结合临床表现及影像学特点综合诊断。

Objective Analysis the relationship of the pregnancy with suprasellar germinoma , and to explore the imaging features of the suprasellar germinoma. Methods A pregnancy with suprasellargerminoma was misdiagnosed as pituitary adenoma after taking MRI exam, Combining pathological and immunohistochemical diagnosed as suprasellar germinoma. Summarize the imaging features of of thesuprasellar germinoma, Contrast the tumor in saddle area （pituitary adenoma and meningiomas）, and the literatures of the pregnancy with suprasellar germinoma were reviewed and retrieved. ResMts Thepregnancy with suprasellar germinoma was occured at gestation with 37 weeks, a mass of soft tissue was discovered in the pituitary fossa, iso-high signal on MRI scan.The lesions were usually obviously andinhomogeneously enhanced, protruded into the suprasellar cistern, bilateral cavernous sinus was pressed,sella was expanded. The patients was raked with emergency cesarean section, emergency endoscopic transsphenoidal tumor resection with anesthesia was taked after three days, The specimens was adopted pathological andimmunohistochemical examination, diagnosed suprasellar germinoma. Conclusion The pregnancy with suprasellar germinoma was very rare,suprasellar germinoma tends to be misdiagnosed as pituitary adenoma and meningiomas.Correct diagnosis of suprasellar germinoma should base on complete imaging examination and clinical symptoms.