임파구성 뇌하수체염으로 오인된 시상상부 배아종 1예
A case of suprasellar germinoma misdiagnosed as lymphocytic hypophysitis
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초록
본 증례에서는 임파구성 뇌하수체염으로 의심되었던 뇌하수체 종괴가 경과관찰 및 스테로이드 치료에도 반응이 없어 이후 시상상부 배아종으로 확진된 증례이다. 임파구성 뇌하수체염은 시야결손의 비교적 드문 원인 질환이기도 하나, 조직검사를 시행한 부위에 따라 조직학적으로 다른 종양과 감별이 어려운 경우도 있다. 본 증례는 이러한 관점에서 매우 희귀한 경우이며 이에 대한올바른 진단과 병인, 향후 치료에 대해 생각할 수 있는 계기를 삼고자 본 증례를 보고하는 바이다.
Abstract
We report here on a case of a 22-year-old girl with a suprasellar mass that was originally diagnosed as lymphocytic hypophysitis, but it eventually turned out to be a germinoma. She initially underwent partial tumor removal and the tissue diagnosis was suggestive of lymphocytic hypophysitis. 46 months later, she presented with a lateral visual field defect and decreased visual acuity of her right eye. The serum and cerebrospinal β-hCG and α-fetoprotein levels were measured. The β-hCG level was elevated in both, whereas the α-fetoprotein level was detectable in neither. The serum anti-pituitary antibody-1 level was negative. She was reoperated and the permanent section biopsies were compatible with pure germinoma. There was no evidence of meningeal metastasis on her whole spine MRI. She was treated with chemotherapy. (Korean J Med 73:210-215, 2007)
참고문헌 (20)
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