背景:同时发生的颅内和睾丸生殖细胞肿瘤(GCT)极为罕见,导致他们缺乏足够的治疗经验。因此,作者报告了一例这种GCT。
方法:一名5岁男孩因头痛和呕吐入院。计算机断层扫描和磁共振成像表明松果体区域存在GCT的可能性。血清肿瘤标志物甲胎蛋白(AFP)为5,396.1μg/L,β-人绒毛膜促性腺激素水平在正常范围内。随后,肿瘤被切除了,最终病理结果为混合GCT。因此,增加了化疗和放疗。然而,作者同时在超声检查中发现了一个睾丸肿瘤,手术后病理提示成熟的囊性畸胎瘤。治疗后,病人恢复得很好,AFP水平下降到正常值。
结论:据作者所知,本报告是第4例同时发生颅内和睾丸GCT,也是第1例同时发生松果体区和睾丸成熟畸胎瘤的混合GCT.手术的组合,化疗,松果体区混合GCT的放射治疗和睾丸生殖细胞肿瘤的手术切除对这些患者是有效的,但需要长期监测。
BACKGROUND: Simultaneous intracranial and testicular germ cell tumors (GCTs) are extremely rare, leading to a lack of adequate experience in their treatment. Therefore, the authors report a case of this kind of GCT.
METHODS: A 5-year-old boy was admitted to the hospital with headache and vomiting. Computed tomography and magnetic resonance imaging suggested the possibility of a GCT in the pineal region. The value of the serum tumor marker alpha-fetoprotein (AFP) was 5,396.1 μg/L, and β-human chorionic gonadotropin levels were within the normal range. Subsequently, the tumor was removed, and the final pathological result was a mixed GCT. Therefore, chemotherapy and radiation were added. However, the authors found a testicular tumor on ultrasound at the same time, and pathology after surgery suggested a mature cystic teratoma. Following treatment, the patient recovered well, and AFP levels dropped to normal values.
CONCLUSIONS: To the authors\' knowledge, this report is the fourth case of simultaneous intracranial and testicular GCTs and the first case of a simultaneous mixed GCT in the pineal region and mature teratoma of the testis. A combination of surgery, chemotherapy, and radiation therapy for mixed GCTs in the pineal region and surgical excision for testicular reproductive cell tumors are effective in these patients, but long-term monitoring is required.