- 期刊
Ntrasellar and Suprasellar Germinoma
蝶鞍內及碟胺上胚芽瘤－病歷報告
摘要
胚芽瘤是一個對放射線治療極敏感，可能可治癒的一種腫瘤，而顱內胚芽瘤大多發生在腦中線的位置，以松果體區最為常見，蝶鞍內胚芽瘤極為少見，其診斷大多靠開刀切片經病理證實，其它的檢查包括電腦斷層，多無法區分胚芽瘤與腦下垂體腺瘤。我們報告一例 15 歲男性的蝶鞍內及蝶鞍上區胚芽瘤，其臨床上以尿崩症，頭痛及雙顯側偏盲為表現。我們並回顧文獻，尤其有磁振攝影報告的病例，以期找出胚芽瘤在磁振攝影上的特殊表現，發現在腦下垂體後葉缺乏高強度信號及注射顯影劑後腦下垂體後葉可看到顯影加強的腫瘤。如果臨床上又有尿崩症，則在年青人應考慮胚芽瘤的可能性高於腦下垂體腫瘤。
關鍵字
無資料並列摘要
A 15-year-old male was admitted to our hospital with diabetes Insipidus, headache and bitemporal hemianopla and a computed tomogram (CT) revealed an intra-and suprasellar tumor. Differential diagnosis between large lntra- and suprasellar germinoma and pituitary adenomas is quite difficult based on CT. After comparing our case with past literature of reported cases of Intrasellar and suprasellar germinoma, we found that an enhanced mass posterior to the pituitary gland on the midsagittal magnetic resonance imaging (MRI) and absence of the high signal intensity of the posterior lobe on Ti-weighted MRI In patients with diabetes insipidus indicated germinoma rather than a pituitary adenoma. Transphenoid approach and appropriate radiotherapeutic management were administered with a good result.
延伸閱讀
- Wang, J. N., Lin, S. J., Chio, C. C., & Liu, H. M. (1995). 上蝶鞍胚胎瘤：一病例報告. Acta Paediatrica Sinica, 36(6), 438-441. https://doi.org/10.7097/APS.199512.0438
- Chen, S. Y., Yang, M. Y., & Shen, C. C. (2010). 松果體區生殖細胞瘤合併同時小腦硬腦膜下轉移與脊椎硬膜外轉移. Journal of Medical Sciences, 30(6), 269-271. https://doi.org/10.6136/JMS.2010.30(6).269
- Kuo, Y. S., Chang, C. J., Huang, S. H., & Sun, C. M. (2015). 偶然發現的腦下垂體大腺瘤在影像上呈現蝶竇的原發腫瘤. 核子醫學暨分子影像雜誌, 28(1), 49-53. https://doi.org/10.6332/ANMMI.2801.008
- Wang, C. J., Howng, S. L., & Huang, J. S. (1996). 蝶鞍內腦膜瘤. The Kaohsiung Journal of Medical Sciences, 12(8), 486-490. https://doi.org/10.6452/KJMS.199608.0486
- 呂宜興、黃榮貴、曾岐元（1998）。翼狀窩之紡錘狀細胞橫紋肌肉瘤－病例報告。中華民國耳鼻喉科醫學會雜誌，33(2)，158-161。https://doi.org/10.6286/1998.33.2.158