大脳基底核部に発生したgerminoma with syncytiotrophoblastic giant cells（STGC）の1例

A case report of germinoma with syncytiotrophoblastic giant cells (STGC) in the basal ganglia

I．はじめに

　頭蓋内胚細胞腫瘍は松果体，鞍上部に好発し，基底核部に発生することは少ない^2,4,6）．今回われわれは基底核部に発生したgerminoma with syncytiotrophoblasticgiant cells（以下STGC）の1症例を経験したので文献的考察を加えて報告する．

We report a case of germinoma with syncytio-trophoblastic giant cells (STGC) in the basal ganglia which was encountered at the Department of Neuro-surgery, Hiratsuka City Hospital, Kanagawa, Japan.

A 9-year-old boy was admitted to our hospital on September 13th, 1993 because of left hemiparesis and precocious puberty. Endocrinological examination re-vealed a high serum level of human chorionic gonado-tropin (HCG) (290mIU/ml) and β-subunit human cho-rionic gonadotropin (HCG-β) (1.3ng/ml). Plain CT scan showed an irregularly-defined mass lesion in the right basal ganglia, which had several low density spots and was inhomogeneously enhanced on contrast CT scan. The tumor developed from the right putamen to the thalamus and showed a tendency towards involve-ment of the hypothalamic region on MR imaging. Weperformed a right front-temporal craniotomy on 29th September, 1993, and a piece of the tumor was re-moved. It was histologically diagnosed to be germino-ma with STGC.

We treated the patient with carboplatin and etopo-side (CBDCA 200mg/m²day1, VP-16 60mg/m²day1-5) chemotherapy and radiotherapy (local 30Gy) after surgery. Postoperative course was good without recur-rent signs. He is now in good health and going to elementary school without neurological deficit. There are very few reports of germinoma with STGC arising in the basal ganglia. We provide a new treatment of germinoma with STGC, chemotherapy and radiotherapy after surgery.