[Primary intrasellar germinoma with amenorrhea--a case report].

A 22-year-old woman with a history of headaches and secondary amenorrhea is reported. Her physical examination showed a visual acuity loss. An endocrine evaluation revealed hypopituitarism and an elevated level of serum prolactin. Polytomography demonstrated an enlarged sella with a double floor. A computerized tomography (CT) scan revealed an enhancing lesion within the sella turcica with an extension into the suprasellar cistern. A lumbar puncture was performed and the cerebrospinal fluid was found to contain no tumor cells. The patient subsequently underwent a trassphenoidal exploration of the sella and an intrasellar tumor removal. A histological analysis of the surgical specimen revealed a germinoma. A total dose of 3500 rads with lineac was applied to the whole brain postoperatively. Her vision is now normal. The pathogenesis of an intracranial germinoma is briefly discussed, and a review of the literature discloses 48 previous reports of germinoma.

[Diffuse metastatic leptomeningeal carcinomatosis (DMLC)].

Diffuse metastatic leptomeningeal carcinomatosis (DMLC) due to systemic cancer has been diagnosed clinically in 7 patients. The primary sites involved were the stomach, the lung, and the breast. In all patients, there was progressive clinical deterioration, the average survival after diagnosis being 18 weeks. Also, leptomeningeal metastases was found to be present in 7 or 47 (14.9%) patients with metastatic brain tumors at the National Kanazawa Hospital. The clinical diagnosis was confirmed by the presence of malignant cells in the cerebrospinal fluid, which showed a decrease in glucose and an increase in the protein content. Ommaya reservoirs were placed in two patients. Treatment consisted of intrathecal injections of either Methotrexate (MTX) alone or MTX and Cytosine arabinoside and venous injections of ACNU in combination with radiation therapy of the brain and the spine.

[Brain metastases of colorectal cancer--a case report].

Metastatic brain tumors from colorectal cancers are relatively rate. In previous reports, the incidence, ranged from 1.9 to 3.5 percent of all metastatic brain tumors. We reported 2 cases of metastatic brain tumors from colorectal cancers. Metastasis to the lung and liver were not found in 2 cases at the time of the diagnosis of the single brain metastasis. The CEA levels in the serum were highly elevated in these 2 cases. On a contrast-enhanced CT scan, tumors were equally demonstrated as high density and cystic, with a ring-like mass with surrounding brain edema. Brain metastases of colorectal cancer were discussed with a review of the literature.

[Extracranial recurrence of sphenoidal ridge meningioma--a case report].

A 46-year-old woman with right sphenoidal ridge meningioma (alar type), which recurred in the orbit and the pterygomaxillary fossa three years after total removal, is presented. Histologically the first examination showed transitional type meningioma. She noticed right exophthalmos, ophthalmoplegia, visual disturbance and swelling of the right side of the face three years later. Microscopically, the tumor showed malignant meningioma. Electron microscopic examination of the specimen disclosed the nucleoli lying on the nuclear membrane, interdigitation with desmosomes, polymorphous mitochondria, free ribosomes, glycogen granules and an enlarged Golgi apparatus. In conclusion, this patient had a transitional type of meningioma when it first presented, but developed malignant histological features invasion at extracranial sites three years later.