The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Rare Case of Primary Spinal Cord Germinoma Treated with Single Radiation Therapy after Surgery

수술 후 방사선 단독 치료를 시행한 원발성 척수 종자세포종 1예

  • Jeong, Joon Won (Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Roh, Sang Young (Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yang, Ji Hyun (Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Ro, Sang Mi (Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Junguee (Department of Pathology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, In-Ho (Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 정준원 (가톨릭대학교 의과대학 서울성모병원 종양내과) ;
  • 노상영 (가톨릭대학교 의과대학 서울성모병원 종양내과) ;
  • 양지현 (가톨릭대학교 의과대학 서울성모병원 종양내과) ;
  • 노상미 (가톨릭대학교 의과대학 서울성모병원 종양내과) ;
  • 이정의 (가톨릭대학교 의과대학 대전성모병원 병리과) ;
  • 김인호 (가톨릭대학교 의과대학 서울성모병원 종양내과)
  • Received : 2017.08.06
  • Accepted : 2017.12.28
  • Published : 2018.08.01
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Abstract

A 32-year old male came to our hospital with chief complaint of paraplegia. He had symptom of radiating pain to right leg 3 months ago before paraplegic symptom appeared. Magnetic resonance (MR) imaging from outside hospital showed intramedullary mass involving from T8 to T10 level of spinal cord. According to the imaging result, tumor removal with total laminectomy was performed between T8 and T10 level in our hospital. Pathologic result was compatible with germinoma. Spine radiation (39.6 Gy/22 fx) from T7 to T12 level without chemotherapy was performed 3 weeks later since tumor removal. Follow-up MR imaging showed no recurrence without any distant metastasis. And our patient's neurologic symptom had been improved. According to this case, postoperative radiotherapy is thought to be effective to primary spinal germinoma.

원발성 척수 종자세포종은 매우 드물게 발생하는 질환으로 국내에서는 아직까지 문헌상으로 보고된 증례가 매우 드물기에, 저자들의 병원에서 발견된 예를 경험하고 보고하는 바이다. 영상 검사만으로는 감별진단이 어려울 수 있으므로 조직학적 검사가 거의 항상 요구되며, 조직 소견에서 융합세포영양막성 거대세포의 존재 유무는 질병의 경과 및 재발을 예측하게 해주는 중요한 지표이므로 이를 반드시 확인하는 과정이 필요하다. 수술적 치료 후에는 방사선 치료나 항암치료를 시행할 수가 있으나 종자세포종은 일반적으로 방사선치료에 좋은 반응율을 보이므로, 본 증례에서는 수술적으로 완전절제 후 방사선 치료를 시행함으로써 현재까지 재발의 소견이 없는 상태이다.

Keywords

References

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