眠気など多彩な症状により発見された鞍上部胚細胞腫瘍の1例

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  • Suprasellar Germ Cell Tumor Diagnosed with Various Symptoms Including Sleepiness: A Case Report
  • ネムケ ナド タサイ ナ ショウジョウ ニ ヨリ ハッケン サレタ アンジョウブハイサイボウ シュヨウ ノ 1レイ

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<p>Germ cell tumors (GCTs) originate from embryonic cells at various stages of maturation and account for approximately 3% of all brain tumors, with Asian countries having a higher incidence than Europe and the United States. GCT-onset is usually during adolescence, accounting for about a quarter of all childhood brain tumors. They occur in the pineal and suprasellar regions, with > 60% of suprasellar tumors known to cause enuresis, decreased visual acuity, short stature, and premature puberty. We report the case of an atypical suprasellar GCT in a patient with atypical and variable symptoms, such as excessive daytime sleepiness and learning disabilities. The patient was a 14-year-old girl, who had no previous history. At X-3 years, she began getting up at night to urinate. At X-2 years, she started drinking 2-3 L of water a day. Several months ago, her homeroom teacher began noticing the patient falling asleep in class. Her grades dropped, and her height was noted on a physical exam. Based on careful interview and detailed examination, intracranial lesions were suspected, and despite the patient's diverse symptoms, magnetic resonance imaging was performed relatively quickly, which allowed for early diagnosis. Although the patient was an adolescent in transition between pediatric and adult medicine, we were able to follow up with the Department of Hypertension and Endocrinology and Department of Neurosurgery at our hospital from diagnosis to treatment. Even for school-aged children, a medical history from both the patient and their family can provide clues for diagnosis.</p>

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