頭蓋内Human Chorionic Gonadotropin (HCG) 産生腫瘍 : 内分泌学的所見と病理組織学的検討

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We are reporting 4 cases of the intracranial human chorionic gonadotropin (HCG) producing tumors. Case 1 was a 21-year-old female with visual disturbance, diabetes incipidus, and hypogonadism. Case 2 was an 11-year-old male with visual disturbance, diabetes incipidus and precocious puberty. Case 3 and 4 were 10-year-old males who had progressive left hemiparesis and precocious puberty. According to the endocrinological examination of hypothalamic pituitary function by radioimmunoassay, serum luteinizing hormone (LH) levels were abnormally high, and serum follicle stimulating hormone (FSH) levels were scanty in all cases. As the result of radioimmunoassay using antibody to native HCG and β-subunit of HCG, native HCG as well as α- and/or β-subunit of HCG were identified in sera of all cases, in CSF of 2 cases, in tumor tissue of 1 case and in urine of 1 case. Tumors were confirmed to be located in suprasellar, hypothalamic and thalamic region by neuro-radiological examinations. Two out of four cases were operated and were diagnosed to be choriocarcinoma and two-cell-pattern pinealoma (germinoma). Following LINEAC irradiation in all cases, HCG levels in the serum and in the CSF became negligible. Serum LH and FSH levels in all cases and plasma testosterone concentration in 3 males who were diagnosed as precocious puberty fell into normal range. Histologically, a part of intracranial human chorionic gonadotropin producing tumors seemed to be germ cell origin. Endocrinological examinations by radioimmunoassay are very useful to make diagnosis and therapy as well as to predict prognosis.
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頭蓋内Human Chorionic Gonadotropin (HCG) 産生腫瘍 : 内分泌学的所見と病理組織学的検討

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