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头颈部病例75分析
An18-year-oldmanpresentswithdiabetesinsipidus.18岁男子，尿崩症。
A
B
(A,B)SagittalandcoronalT1-weightedpostcontrastimageswereobtained.Thereareenhancinglesionslocatedbothwithinthesellaturcica(arrow)aswellaswithinthepinealregion(arrowhead).Enhancingsofttissueisalsonotedalongtheseptumpellucidum(circle).
(A，B)矢状位和冠状位T1WI增强扫描。鞍内(箭头)和松果体区(箭头)均有强化病灶。沿透明隔(圆圈)也可见软组织强化。
DifferentialDiagnosis
?Germcelltumor(GCT):Agoodchoiceduetoinvolvementofboththepinealbedandthesellarregionsinayoungmalepatient.
?Metastasis:Multiplefocalareasofintracranialenhancementraisethepossibilityofmetastaticdisease.
?Quadrilateralretinoblastoma:Couldbeseenwithinfant/youngchildinvolvementofretinoblastoma,includingbilateralorbits,sellar/suprasellar,andthepinealregions.
鉴别诊断
?生殖细胞瘤(GCT)：年轻男性患者，累及松果体床和鞍区。
?转移：颅内多灶性强化病灶需考虑转移性疾病的可能性。
?四侧性视网膜母细胞瘤：见于婴幼儿或小孩视网膜母细胞瘤，包括双侧眼眶、鞍区/鞍上区和松果体区肿瘤。
EssentialFacts
?Tumorsderivedfromgermcellsincludeseminomas/germinomasaswellasothercelllinessuchaschoriocarcinomasandyolksactumors.
?Intracranialinvolvementcanbeprimaryorsecondary.Bothformsareusuallyseeninchildhoodandyoungadultpatientpopulations.
?Patientscanpresentwithavarietyofsymptoms,includingdiabetesinsipidusorhormonalabnormalitiesduetosellarinvolvement,hydrocephalusfrompinealinvolvement,orParinaudsyndromedueto
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