血清中のAFPおよびHCGがともに著明な高値を示した鞍上部悪性Germ cell tumorの1例

Primary Intracranial Malignant Germ Cell Tumor Associated with Abnormal High Value of Alpha-fetoprotein and Human Chorionic Gonadotropin

I．はじめに

　最近radioimmunoassayの目ざましい発展により腫瘍マーカーであるalpha-fetoprotein（以下AFP）やhumanchorionic gonadotropin（以下HCG）を産生する頭蓋内原発のgerm cell tumorの報告がみられるようになってきた．しかしながらAFPおよびHCGがともに高値を示した症例の報告はいまだ少ない^{7,12,16,17,19,20）}．われわれは鞍上部に発生しAFPおよびHCGがともに高値を示した悪性germ cell tumorを経験し，術後，cisplatin，vincristin,bleomycinの3者併用療法（以下PVB療法）を行い，良好な結果を得たので報告する．病理組織学的にはgerminoma with syncytiotrophoblastic giant cellsand immature teratomaの混在型であり，免疫組織学的にもAFP,HCGの腫瘍内局在を証明しえたので，若干の文献的考察を加え報告する．

A case of primary suprasellar germ cell tumor that produced alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in a 8-year-old boy is reported.

Partial removal of tumor and combination chemo-therapy using cisplatin, vincristine, and bleomycin (modified PVB therapy) resulted in an almost definite regression of the tumor and improvement from clinical symptoms in this case. After the chemotherapy the con-centrations of both serum AFP and serum HCG de-creased to normal levels as well. Moreover by the im-munoperoxidase method AFP, HCG, and placental alkaline phosphatase were found in this particular tumor tissue.