RADIOTHERAPY OF GERM CELL TUMOR IN BASAL GANGLION:CASE REPORT AND REVIEW OF LITERATURE

顱內胚細胞瘤之放射線治療：病例報告及文獻回顧

葉慧玲(Hui-Ling Yeh) ； 詹建勝(Jian-Sheng Jan)

《放射治療與腫瘤學》 10卷2期 (2003/06) Pp. 113-118

https://doi.org/10.6316/TRO/200310(2)113

摘要

一名十五歲男性因突發性右側無力住院。經腦部電腦斷層掃瞄於左腦基底核發現一巨大囊狀腫瘤。因無法以核磁共振掃瞄及腦部血管攝影檢查排除為動靜脈畸形瘤，於是開刀取樣化驗。經病理報告實為顱內胚細胞後，施以劑量全腦放射線治療，並於原病灶以三度空間順形放射線治療方式補強劑量。病人術後血中HCG及AFP濃度偏高，於放射治療後皆下降至低於正常值。放射線治療後三個月於病人的腦部電腦斷層掃瞄中並未發現殘餘腫瘤。病人於放射線治療後，其右側無力之現象已明顯改善。病人於治療中並無急性副作用，追蹤至今無明顯神經性後遺症。本文藉此罕見病例分享治療經驗及回顧近期文獻記錄。

關鍵字

顱內胚細胞瘤,三度空間順形放射線治療

並列摘要

A 15 year-old boy was sent to our Neurologic Department because of severe headache and sudden onset of right hemiparesis. Neurologic exarmination showed motor dysfunction of right upper limb, bilateral temporal visual field deficits and impaired visual acuity. Computer tomographic scan and magnetic resonance imaging showed a mass lesion in the left basal ganglion region. He received craniotomy for partial resection of the tumor and the nature of the tumor was proved to be germinoma, histologically. He was then treated by radiotherapy with a mean dose of 21 Gy to the whole brain and an additional boosting dose of 20 Gy to the tumor bed by three-dimensional conformal radiotherapy. There was an elevation in the serum concentration of beta-human chorionic gonadotropin (B-HCG) and alfa-fetoprotein (AFP) after the operation which suggested the possibility of other germ cell components in the tumor. However, the response of radiotherapy was good. No acute radiation toxicity was noted during irradiation and the muscle power of his right arm improved after follow-up for one year until the present. Long-term follow-up and further clinical studies are needed to determine the benefit of this moderate dose radiotherapy.

並列關鍵字

Intracranial germinoma,3D-conformal radiation therapy