原发性颅内生殖细胞瘤

患者1年前出现右手抖,右侧肢体肌力下降,2个月前出现头痛及癫痫样发作一次,行CT检查发现颅内占位,行左额颞叶占位性病变次全切除术,术后病理诊断为:左额颞叶生殖细胞瘤。经过多学科讨论认为原发性颅内生殖细胞瘤为少见病,放疗为其最主要治疗手段,具有较高的治愈率,应继续关注联合放化疗在该病治疗中的应用进展,这可能有助于我们在保持疗效的情况下减低放疗的远期毒副作用。对于该例患者,我们给予了根治性放疗,先行全中枢放疗,随后缩野至瘤床局部推量,完成后再次缩野至肿瘤实质区放疗,总放疗剂量为46.8Gy。并在放疗后予PEB方案辅助性化疗2程。治疗结束后1周复查MR疗效评价为CR。

Primary Intracranial Germinoma

]A 16-year-old patient presented with right hand quiver and right limbs weakness for 1 year. The patient had a headache for 2 months and had a seizure. CT scan demonstrated an intracranial mass in the left frontal and temporal lobe. The patient reiceived subtotal resection, pathological exmination conformed the diagnosis of germinoma. Clinical case discussion was arranged and treatment procedure was planned through a group of specialists. The primary intracranial germinoma is a rare disease, and the radiotherapy is the efficient treatment. We think it is worthy to pay close attention to the advancement of combined chemo-radiotherapy, it may be efficient to reduce the toxicity of radiotherapy to the young patients by reduce the irradiation dose and area to the central nerve system. For this patient, we treated him with radical radiotherapy: first applied whole central nerve system irradiation, then boosted the tumor bed with the total dosage of 46.8Gy. The patient had radical radiotherapy and 2 cycles of PEB adjuvant chemotherapy. MRI scan at 1 month after the treatment demonstrated a complete remission of the tumor.