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Case No. 480
2018-05-01~2018-05-31
출제자 : 이아름
Hit : 331
| Period | 2018-05-01~2018-05-31 |
|---|---|
| Diagnosis | Germinoma |
| Clinical information | 20/M C.C: Lt. hemiparesis |
| Discussion | -CSF dissemination : not uncommon -Clinical Sx. & signs - Pineal: Parinaud syndrome, headache - Suprasellar : DI, visual loss, hypothal.-pituitary dysfunction - BG/thalamus: Non-specific Sx Larger size, more cystic / hemorrhagic -Treatment : Radiotherapy +/- chemotherapy -Prognosis - Pure germinoma : favorable prognosis 5-year survival: 90% - G. with mixed germ cell components: worse px. Basal Ganglia Germinoma • 5-10% of intracranial germinomas (uni-/bilateral) • 10-30 yrs, M >> F • Slowly progressive hemiparesis with neuropsychiatric sx. • Association of cerebral, brain stem hemiatrophy (~33%) • CT/MRI Features Hyperdense on unenhanced CT (high cellularity) Ipsilateral Wallerian degeneration Cystic change and hemorrhage d/t rapid enlargement Heterogeneous dense enhancement • Focal lesion in the BG + 10-30 yrs. of age with progressive hemiparesis + Ipsilateral cerebral/brainstem hemiatrophy consider Germinoma Reference) Diagnostic Imaging Brain I 6; 162-165 AJR 1994; 162:1413-1417 Pediatr Radiol (2006) 36:325-330 |
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