儿童中枢神经系统生殖细胞肿瘤的诊断与治疗策略

中枢神经系统生殖细胞肿瘤(central nervous system germ cell tumors,CNS GCTs)是儿童常见的颅内恶性肿瘤之一。目前国际上治疗儿童CNS GCTs常采用化疗、放疗、手术等综合治疗手段。CNS GCTs的临床表现、发生位置以及肿瘤成分均十分复杂,治疗方案和治疗结局多样,不同病理类型患者预后差异明显,使得CNS GCTs的处理较为复杂,因此需要通过多学科合作的综合评估与治疗以获得良好的临床结局。对患者进行全面评估、早期诊断、早期治疗,可进一步提高儿童原发性CNS GCTs的生存率,改善患者生存质量。

脐尿管癌的诊断与治疗(附12例报告)

目的探讨脐尿管癌的诊断与治疗的方法,提高对脐尿管癌的认识及诊治水平。方法总结12例脐尿管癌的诊治经验。结果1年生存率66.7%(8/12)、3年生存率41.7%(5/12)、5年生存率16.7%(2/12)。结论最常见的临床表现是耻骨上肿块、血尿、尿频和尿中有黏液。CT、膀胱镜检查是诊断脐尿管癌的最好方法。治疗应行扩大性膀胱部分切除术,强调不仅切除膀胱顶部,且将覆盖肿瘤的腹膜以及与R etz ius间隙相连的组织一起切除。脐尿管癌的预后较差。联合放疗、化疗和免疫治疗可望提高远期生存率。

Role of MR imaging in the diagnosis of intracranial germinoma

Objective: To investigate the role of MRI in the diagnosis of intracranial germinoma. Methods: MRI features of 19 cases of intracranial germinoma confirmed by operations and pathological findings were analyzed retrospectively. Results: Germinomas were found in the sellar region in 10 patients (including 5 males and 5 females), in the pineal region in 6 and in the thalamus and basal ganglia in 3, the 9 patients in the latter 2 groups all being males. The characteristic MRI findings of intracranial germinomas were as follows: (1) Lesions were isointense or slightly hypointense on T1WI while isointense or slightly hyperintense on T2WI. The germinomas in the sellar region and pineal region showed no edema, but lesions in the thalamus basal ganglia showed mild to moderate edema and space-occupying effects. (2) Homogeneous or inhomogeneous Gd-DTPA enhancement were seen in most of the tumors. Conclusion: Multiaxial imaging and Gd-DTPA enhancement in MRI are helpful in the diagnosis and differentiation of intracranial germinomas on the basis of the patient's gender, the location of the tumor and its imaging characteristics.