Germinoma of the Medulla Oblongata —Case Report—

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  • SUGIYAMA Kazuhiko
    Department of Neurosurgery, Hiroshima University School of Medicine
  • UOZUMI Tohru
    Department of Neurosurgery, Hiroshima University School of Medicine
  • GOISHI Junji
    Department of Neurosurgery, Matsuyama Red Cross Hospital
  • SOGABE Takashi
    Department of Neurosurgery, Matsuyama Red Cross Hospital
  • ARITA Kazunori
    Department of Neurosurgery, Hiroshima University School of Medicine
  • MAEDA Hitoshi
    Department of Neurosurgery, Hiroshima University School of Medicine
  • IKAWA Fusao
    Department of Neurosurgery, Hiroshima University School of Medicine

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A 32-year-old female presented with medulla oblongata germinoma manifesting as numbness in the extremities. Computed tomography demonstrated a mass in the medulla oblongata expanding into the fourth ventricle. The tumor was partially removed. Immunohistochemical staining of the tumor specimen demonstrated large epithelioid cells positive for placental alkaline phosphatase, and syncytiotrophoblastic cells positive for β subunit of human chorionic gonadotropin. Some epithelioid cells were also positive for cytokeratin. She received 44 Gy of irradiation to the posterior fossa and 20 Gy whole spinal irradiation. No signs of recurrence have occurred for 9 years. Patients with medulla oblongata germ cell tumor are comparatively older than those with other intracranial germ cell tumors and have two X chromosomes. All tumors were diagnosed as germinoma, and caused symptoms of involvement of the lower cranial nerves and the lower brain stem without pyramidal tract signs.

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