脑实质内生殖细胞瘤临床特点

Clinical Features of Germinoma Arising from Brain Parenchyma

目的 探讨脑实质内生殖细胞瘤的特点。方法 总结 5例脑实质内生殖细胞瘤的临床表现和辅助检查结果 ,并回顾复习相关文献。结果 5例患者全部为男性 ,平均发病年龄 2 0 .2岁 ,最常见的临床症状是偏侧肢体无力 ,一般呈慢性进展性病程。部分患者伴有性早熟及血、脑脊液人绒毛膜促性腺激素、胎盘碱性磷酸酶升高。CT、MRI扫描显示 ,肿瘤组织信号混杂不均 ,边界不清 ,一般伴有斑片或环状不规则增强。结论 脑实质内生殖细胞瘤是一种好发于儿童和少年期男性的少见病 ,临床表现缺乏特异性 ,正确的诊断依赖于对患者症状、体征和辅助检查结果的综合分析 。

Objective To explore the clinical features of germinoma arising from brain parenchyma. Methods The clinical manifestation and results of auxiliary examination were summarized,and the related literature were reviewed. Results 5 patients were all male. The average onset age was 20 2 years. The clinical manifestation was characterized by slowly progressive course and hemiparesis as the most common symptom. Precocious puberty,elevation of CSF and/without serum level of human chorionic gonadotropin and placental alkaline phosphatase were present in part of the patients. On CT or MRI,the tumor usually turned out to be an irregularly defined area with inhomogenous signal intensity and significant irregular enhancement. Intratumorous cysts, calcification and hemorrhage were frequently observed. Conclusions Brain parenchyma germinoma is a rare disease that mostly occur in childhood or adolescent male. They usually lack specific clinical manifestation. Diagnosis must be established by analyzing the patient clinical feature and results of auxiliary examination as a whole. Sometimes biopsy is indispensable.