大脳基底核部原発germinoma—CTスキャンにて経過追求しえた1症例の報告と文献的考察

INTRACEREBRAL GERMINOMA DEVELOPING IN THE RIGHT BASAL GANGLIA : REPORT OF A CASE FOLLOWED UP BY CTSCAN AND REVIEW OF THE LITERATURE

Ⅰ．はじめに

　松果体部以外の頭蓋内原発germinorna （いわゆる異所性松果体腫ectopic pinealoma）の好発部位は鞍上部，第3脳室とされ，その他の部位に発生することはまれで，そのまとまつた報告もほとんどされていない，最近著者らは，左半身運動不全麻痺で発症した大脳基底核部原発germinomaの1例を経験し，その増大過程，治療効果をCTスキャンにて追跡しえたので報告し，併せて文献報告例の調査結果を中心に考察を加えたい。

Recently, a case of intracranial germinoma in the right basal ganglia was experienced in our department. He was a 14-years old boy with left motor hemiparesis. On repeated CT studies (7 times), developmental process of the tumor was observed for about 2 years.

The tumor developed from the right putamen and invaded toward it's neighboring area (right basal ganglia, thalamus and hypothalamus). As the tumor grew larger, multiple cysts were formed in the tumor tissue and dislocation of ventricles occurred. On 21 December 1978, right temporal craniotomy was performed and a piece of the tumor was removed.

It's tissue was diagnosed as germinoma by patho-histological examination. As the effect of posto-perative ⁶⁰Co irradiation and chemotherapy (Vin-cristine, CCNU), tumor stain (high density area) on CT scan disappeared and remained only as a well margined low density area. On CT scan in September 1979, recurrence sign was not noted. Clinical features of the germinoma located in the basal ganglia has not been well known, because of it's rarity.

As a result of the survey of 7 cases reported in the Japanese literature and our case, it has been made clear that most of them are characterized by motor hemiparesis in the early stage, not ac-companied by intracranial hypertension.