{"id":140,"date":"2012-04-17T23:14:44","date_gmt":"2012-04-17T14:14:44","guid":{"rendered":"\/sawamura\/wp\/?p=140"},"modified":"2026-01-15T17:38:08","modified_gmt":"2026-01-15T08:38:08","slug":"pinealtumor","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/pinealtumor\/","title":{"rendered":"\u677e\u679c\u4f53\u816b\u760d pineal tumor"},"content":{"rendered":"\n<h5 class=\"wp-block-heading\">\u5c71\u672c\u54f2\u54c9\u3082\u8a18\u8f09\u3057\u3066\u3044\u307e\u3059<\/h5>\n\n\n\n<h5 class=\"wp-block-heading\"><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/contact_yamamoto\/\">\u677e\u679c\u4f53\u816b\u760d\u306b\u95a2\u3057\u3066\uff0c\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u306e\u5c71\u672c\u54f2\u54c9\u5148\u751f\u304c\u5fa1\u76f8\u8ac7\u306b\u306e\u308a\u307e\u3059\uff0c\u76f8\u8ac7\u3057\u305f\u3044\u65b9\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u304f\u3060\u3055\u3044<\/a><\/span><\/h5>\n\n\n\n<p>\u5c71\u672c \u54f2\u54c9\uff08\u3084\u307e\u3082\u3068 \u3066\u3064\u3084\uff09<br>\u3000\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u9644\u5c5e\u75c5\u9662 \u8133\u795e\u7d4c\u5916\u79d1 \u8a3a\u7642\u79d1\u90e8\u9577<br>\u3000\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66 \u8133\u795e\u7d4c\u5916\u79d1 \u4e3b\u4efb\u6559\u6388<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u677e\u679c\u4f53\u3068\u306f<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8133\u306e\u771f\u3093\u4e2d\u3001\u6df1\u3044\u3068\u3053\u308d\u306b\u3042\u308b\u5c0f\u3055\u306a\u7d44\u7e54\u3067\u3059<\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u306f\uff0c\u7761\u7720\u306e\u30d1\u30bf\u30fc\u30f3\u3092\u8abf\u7bc0\u3059\u308b\u30e1\u30e9\u30c8\u30cb\u30f3(\u30db\u30eb\u30e2\u30f3)\u3092\u4f5c\u3063\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u771f\u306e\u6a5f\u80fd\u306f\u8b0e\u306e\u5185\u5206\u6ccc\u5668\u5b98\u3067\u3059<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"550\" height=\"456\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptid11-550x456.jpg\" alt=\"\" class=\"wp-image-3203\" title=\"pptid1\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptid11-550x456.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptid11-300x249.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptid11.jpg 850w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/figure>\n<\/div>\n\n\n<div><\/div>\n\n\n\n<div style=\"padding-left: 40px;\">\u7dd1\u306b\u307f\u3048\u308b\u306e\u304c\u677e\u679c\u4f53\u816b\u760d\u3067\u3059\u3002\u982d\u306e\u4e2d\u5fc3\u90e8\u306e\u5965\u6df1\u3044\u3068\u3053\u308d\u306b\u3042\u308a\uff0c\u8133\u306e\u6df1\u90e8\u9759\u8108\uff08\u9752\u8272\uff09\u306b\u53d6\u308a\u56f2\u307e\u308c\u3066\u3044\u307e\u3059\u3002\u816b\u760d\u3092\u3068\u308b\u6642\u306f\u3068\u3066\u3082\u96e3\u3057\u3044\u624b\u8853\u306b\u306a\u308a\u307e\u3059\u3002<\/div>\n\n\n\n<h4 class=\"wp-block-heading\">\u304a\u304a\u307e\u304b\u306a\u3053\u3068<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u677e\u679c\u4f53\u816b\u760d\u3092\u306a\u305c\u7279\u5225\u6271\u3044\u3059\u308b\u3068\u3044\u3046\u3068\u3001<strong><span style=\"color: #ff6600;\">\u8a3a\u65ad\u3068\u624b\u8853<\/span><span style=\"color: #ff0000;\">\u3068\u6cbb\u7642\u304c\u96e3\u3057\u3044\u816b\u760d<\/span><\/strong>\u3060\u304b\u3089\u3067\u3059<\/li>\n\n\n\n<li>\u3044\u308d\u3044\u308d\u306a\u3082\u306e\u304c\u3042\u308a\u307e\u3059\u304c\uff0c<strong><span class=\"style1\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/germcelltumors\/germinoma\/\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u30af\u30ea\u30c3\u30af\uff09<\/a><span style=\"color: #000000;\"><span style=\"caret-color: #000000;\">\uff0c<\/span><\/span><\/span><\/strong><strong style=\"color: #000000;\"><span class=\"style1\"><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/mixedgermcelltumor\/\">\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\uff08\u30af\u30ea\u30c3\u30af\uff09<\/a><\/span>\uff0c<span style=\"color: #333399;\">\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\uff08\u4e0b\u8a18\uff09<\/span><\/span><\/strong><span class=\"style1\" style=\"color: #333333;\">\u304c\u591a\u3044<\/span>\u3067\u3059<\/li>\n\n\n\n<li>\u8133\u30c9\u30c3\u30af\u306a\u3069\u3067\u5076\u7136\u306b\u767a\u898b\u3055\u308c\u308b\u3053\u3068\u3082\u591a\u304f\u306a\u308a\u307e\u3057\u305f<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong><span class=\"style1 style2\">\u7121\u75c7\u72b6\u306e\u816b\u760d\u306f\u6cbb\u7642\u3092\u3059\u308b\u5fc5\u8981\u304c\u306a\u3044<\/span><\/strong><\/span>\u3053\u3068\u3082\u307e\u308c\u306b\u3042\u308b\u306e\u3067\uff0c\u6cbb\u7642(\u624b\u8853)\u3092\u52e7\u3081\u3089\u308c\u305f\u5834\u5408\u306b\u306f\u614e\u91cd\u306b\u5224\u65ad\u3057\u3066\u304f\u3060\u3055\u3044<\/li>\n\n\n\n<li>\u4e2d\u8133\u6c34\u9053\u3068\u3044\u3046\u9ac4\u6db2\u306e\u51fa\u53e3\u304c\u9589\u3058\u3066\uff0c<strong><span style=\"color: #ff0000;\">\u9589\u585e\u6027\u6c34\u982d\u75c7\u306b\u306a\u308b\u305f\u3081\u306b \uff0c\u982d\u75db\u3068\u5614\u5410<\/span><\/strong>\u3068\u3044\u3046\u75c7\u72b6\u304c\u3067\u307e\u3059<\/li>\n\n\n\n<li>\u7279\u306b\uff0c\u65e9\u671d\u306e\u982d\u75db morning headache \u304c\u677e\u679c\u4f53\u816b\u760d\u306e\u6c34\u982d\u75c7\u306b\u7279\u5fb4\u7684\u3067\u3059<\/li>\n\n\n\n<li>\u4e2d\u8133\u3092\u5f8c\u308d\u304b\u3089\u5727\u8feb\u3059\u308b\u306e\u3067\u76ee\u306e\u52d5\u304d\u304c\u60aa\u304f\u306a\u3063\u3066\uff08\u773c\u7403\u904b\u52d5\u969c\u5bb3\uff09\uff0c<strong><span style=\"color: #ff0000;\">\u7269\u304c\uff12\u3064\u306b\u307f\u3048\u308b<\/span><\/strong>\uff08\u8907\u8996\uff09\u3068\u3044\u3046\u75c7\u72b6\u3082\u591a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u958b\u982d\u624b\u8853\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u816b\u760d\u3068\u305d\u3046\u3067\u306a\u3044\u816b\u760d\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u3068\u3066\u3082\u983b\u5ea6\u304c\u9ad8\u3044<strong><span class=\"style1\" style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"pinealcyst\/\">\u677e\u679c\u4f53\u306e\u3046\u80de<\/a>\u3068\u3044\u3046\u826f\u6027\u306e\u816b\u760d\uff08\u6c34\u304c\u305f\u307e\u3063\u305f\u888b\u72b6\u306e\u3082\u306e\uff09\u306f\u6cbb\u7642\u3092\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u305b<\/span><span style=\"color: #000080;\">\u3093<\/span><\/strong><\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u306e\u3046\u80de\u3092\u624b\u8853\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3068\u3044\u308f\u308c\u305f\u3089\u307e\u305a\u30bb\u30ab\u30f3\u30c9\u30aa\u30d4\u30cb\u30aa\u30f3\u3092\u805e\u304d\u306b\u4ed6\u306e\u75c5\u9662\u3078\u3044\u304d\u307e\u3057\u3087\u3046<\/li>\n\n\n\n<li>\u3082\u3063\u3068\u3082\u983b\u5ea6\u304c\u9ad8\u3044<span class=\"style1\" style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"..\/pediattumor\/germinoma\/\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/a>\u306f\u3001\u5185\u8996\u93e1\u306b\u3088\u308b\u751f\u691c\u8853<\/strong><\/span>\u3092\u884c\u306a\u3044\u307e\u3059\u304c\uff0c\u958b\u982d\u624b\u8853\u306e\u5fc5\u8981\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li><span class=\"style1\" style=\"color: #000080;\"><strong>\u60aa\u6027\u677e\u679c\u4f53\u816b\u760d\u306b\u306f\uff0c<a style=\"color: #000080;\" href=\"..\/pediattumor\/germ\/\">\u60aa\u6027\u80da\u7d30\u80de\u816b\u760d\uff08\u80ce\u5150\u6027\u764c\uff0c\u5375\u9ec4\u56a2\u816b\uff0c\u60aa\u6027\u5947\u5f62\u816b\uff09<\/a>\uff0cPPTID,&nbsp;<a style=\"color: #000080;\" href=\"\/sawamura\/braintumors\/pinealparenchymaltumor\/\" title=\"\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d pineal parenchymal tumor\">\u677e\u679c\u4f53\u82bd\u816b<\/a><\/strong><\/span>\u306a\u3069\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u3053\u308c\u3089\u306e\u4e00\u90e8\u306f\u624b\u8853\u3092\u3057\u306a\u3044\u3067\u307e\u305a\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u5c0f\u3055\u304f\u3057\u3066\u304b\u3089\uff0c\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u305f\u65b9\u304c\u6cbb\u308b\u78ba\u7387\u304c\u9ad8\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u3067\u3059\u304b\u3089\uff0c\u677e\u679c\u4f53\u816b\u760d\u306e\u958b\u982d\u624b\u8853\u306f\u3068\u3066\u3082\u5c11\u306a\u304f\u306a\u308a\u307e\u3057\u305f<\/li>\n\n\n\n<li>\u307e\u305a\u958b\u982d\u3057\u3066\u5168\u6458\u51fa\u3092\u76ee\u6307\u3059\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308b\u306e\u306f\uff0c\u30b0\u30ec\u30fc\u30c9 1\u306e\u677e\u679c\u4f53\u7d30\u80de\u816b\u304b<span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"..\/pediattumor\/germ\/\">\u6210\u719f\u5947\u5f62\u816b<\/a><\/strong><\/span>\u3092\u7591\u3063\u305f\u6642\u3060\u3051\u3067\u3057\u3087\u3046<\/li>\n\n\n\n<li><span class=\"style1\" style=\"color: #ff0000;\"><strong>\u958b\u982d\u624b\u8853\u306f\u3080\u305a\u304b\u3057\u3044\u3057\uff0c\u8853\u524d\u306e\u691c\u67fb\u304b\u3089\u958b\u982d\u304c\u5fc5\u8981\u304b\u3069\u3046\u304b\u306e\u5224\u65ad\u3082\u3080\u305a\u304b\u3057\u3044<\/strong><\/span>\u306e\u3067\uff0c\u6cbb\u7642\u7d4c\u9a13\u306e\u591a\u3044\u8133\u5916\u79d1\u306e\u5148\u751f\u3092\u635c\u3057\u305f\u65b9\u304c\u5b89\u5168\u3067\u3059<\/li>\n\n\n\n<li>\u304a\u305d\u3089\u304f\u79c1\u306f\uff0c\u677e\u679c\u4f53\u816b\u760d\u3068\u3044\u3046\u3082\u306e\u3092\u6cbb\u7642\u304c\u5fc5\u8981\u306a\u3082\u306e\u3060\u3051\u3067\u3082200\u4f8b\u4ee5\u4e0a\u306f\u307f\u3066\u304d\u305f\u3068\u601d\u3044\u307e\u3059\u304c\uff0c\u6cbb\u7642\u65b9\u6cd5\u306e\u9078\u629e\u306f\u8907\u96d1\u3067\u3053\u3053\u306b\u306f\u66f8\u304d\u304d\u308c\u306a\u3044\u3053\u3068\u304c\u305f\u304f\u3055\u3093\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\">\u3068\u306b\u304b\u304f\u6700\u521d\u306eMRI\u8a3a\u65ad\u304c\u5927\u5207\u3001\u305d\u308c\u3067\u6cbb\u7642\u306e\u65b9\u5411\u6027\u304c\u6c7a\u307e\u308a\u307e\u3059<\/h5>\n\n\n\n<div><hr><\/div>\n\n\n\n<div>\n<h4>\u677e\u679c\u4f53\u816b\u760d\u3068\u677e\u679c\u4f53\u90e8\u816b\u760d\u306e\u9055\u3044<\/h4>\n<ul>\n<li>\u677e\u679c\u4f53\u816b\u760d\u3068\u306f\u677e\u679c\u4f53\u304b\u3089\u767a\u751f\u3059\u308b\u816b\u760d\u306b\u9650\u5b9a\u3055\u308c\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u90e8\u816b\u760d\u3068\u306f\uff0c\u677e\u679c\u4f53\u306b\u767a\u751f\u3059\u308b\u816b\u760d\u3068\uff0c\u677e\u679c\u4f53\u8fd1\u508d\u306b\u767a\u751f\u3057\u677e\u679c\u4f53\u3092\u4fb5\u3059\u816b\u760d\u306e\u53cc\u65b9\u3092\u542b\u307f\u307e\u3059<\/li>\n<li>\u8996\u5e8a\u6795\u304b\u3089\u767a\u751f\u3057\u305f\u30b0\u30ea\u30aa\u30fc\u30de \u3001\u5927\u8133\u938c\u30c6\u30f3\u30c8\u63a5\u5408\u90e8\u304b\u3089\u767a\u751f\u3057\u305f\u9ac4\u819c\u816b\u3001\u56db\u4e18\u4f53\u69fd\u306e\u985e\u8868\u76ae\u306e\u3046\u80de\u306a\u3069\u306f\uff0c\u771f\u306e\u677e\u679c\u4f53\u816b\u760d\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3053\u306e\u30da\u30fc\u30b8\u3067\u306f\u3001\u677e\u679c\u4f53\u304b\u3089\u767a\u751f\u3059\u308b\u816b\u760d\u3060\u3051\u3092\u8a18\u8ff0\u3057\u307e\u3059<\/li>\n<\/ul>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h1 class=\"wp-block-heading\"><a title=\"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\" href=\"\/sawamura\/pediattumor\/germinoma\/\"><span style=\"color: #000080;\"><strong>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de germinoma \u306f\u5225\u30da\u30fc\u30b8\u306a\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/strong><\/span><\/a><\/h1>\n\n\n\n<h1 class=\"wp-block-heading\"><a title=\"\u80da\u7d30\u80de\u816b\u760d germ cell tumors\" href=\"\/sawamura\/pediattumor\/germ\/\"><span style=\"color: #000080;\">\u80da\u7d30\u80de\u816b\u760d germ cell tumors \u306f\u5225\u30da\u30fc\u30b8\u306a\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/span><\/a><\/h1>\n\n\n\n<h1 class=\"wp-block-heading\"><a title=\"\u5947\u5f62\u816b teratomas\" href=\"\/sawamura\/pediattumor\/teratoma\/\"><span style=\"color: #000080;\">\u5947\u5f62\u816b teratoma \u306f\u5225\u30da\u30fc\u30b8\u306a\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/span><\/a><\/h1>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk21.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"298\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk21-298x300.jpg\" alt=\"teratowk2\" class=\"wp-image-7692\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk21-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk21-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk21.jpg 332w\" sizes=\"auto, (max-width: 298px) 100vw, 298px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk11.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"288\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk11-288x300.jpg\" alt=\"teratowk1\" class=\"wp-image-7693\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk11-288x300.jpg 288w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/teratowk11.jpg 355w\" sizes=\"auto, (max-width: 288px) 100vw, 288px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>14\u6b73\u306e\u7537\u306e\u5b50\u3067\u3059\u3002\u3053\u306eMRI\u753b\u50cf\u306f\u3069\u3046\u898b\u3066\u3082\u677e\u679c\u4f53\u5947\u5f62\u816b mature or immature teratoma \u4ee5\u5916\u306b\u306f\u8003\u3048\u3089\u308c\u307e\u305b\u3093\u3002\u5de6\u306e\u5199\u771f\u3067\u8102\u80aa\u816b\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u3053\u3068\u304c\u89e3\u308a\u307e\u3059\u3002AFP 130 ng\/ml, HCG-beta 30 mIU\u3067\u3057\u305f\u304b\u3089\uff0c<a title=\"ICE\u5316\u5b66\u7642\u6cd5\" href=\"\/sawamura\/pediattumor\/icechemo\/\">ICE\u5316\u5b66\u7642\u6cd5<\/a>\u3068\u653e\u5c04\u7dda\u6cbb\u7642 (\u5168\u8133\u5ba4 25.2\u30b0\u30ec\u30a4\/15\u5206\u5272\u3068\u5c40\u624028.8\u30b0\u30ec\u30a4\uff0c1\u56de\u7dda\u91cf1.8\u30b0\u30ec\u30a4\uff09\u3092\u3057\u3066\u5c11\u3057\u5c0f\u3055\u304f\u3057\u3066\uff08\u53f3\u306e\u5199\u771f\uff09\u304b\u3089\u958b\u982d\u624b\u8853\u3057\u307e\u3057\u305f\u3002\u5168\u6458\u51fa\u3057\u3066\u75c5\u7406\u8a3a\u65ad\u306f\u6210\u719f\u5947\u5f62\u816b\u3067\u3057\u305f\u304c\uff0c\u6cbb\u7642\u524d\u306b\u306f\u304a\u305d\u3089\u304f\u3082\u3063\u3068\u672a\u719f\u306a\u90e8\u5206\u304c\u6df7\u3058\u3063\u3066\u3044\u305f\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u3002<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">\u8133\u795e\u7d4c\u5916\u79d1\u624b\u8853<\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u75c5\u7406\u8a3a\u65ad\u306e\u305f\u3081\u306e\u751f\u691c\u8853\u306f<span style=\"color: #000080;\"><strong>\u5185\u8996\u93e1<\/strong><\/span>\u3067\u884c\u3044\u307e\u3059<\/li>\n\n\n\n<li><span style=\"color: #000080;\">\u958b\u982d\u624b\u8853\u3067\u816b\u760d\u3092\u5168\u90e8\u6458\u51fa\u3059\u308b\u6642\u306b\u306f\u3001<a style=\"color: #000080;\" href=\"\/sawamura\/surgtech\/ota\/\" title=\"OTA \u7d4c\u30c6\u30f3\u30c8\u6cd5 occipital transtentorial approach\"><span style=\"color: #000080;\"><strong>\u7d4c\u30c6\u30f3\u30c8\u6cd5 OTA occipital transtentorial approach&nbsp;<\/strong><\/span>\u3067\u884c\u3044\u307e\u3059<\/a>\uff08<\/span><span style=\"color: #000080;\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/surgtech\/ota\/\">\u9ad8\u5ea6\u306e\u5c02\u9580\u5bb6\u5411\u3051\u306b\u5225\u30da\u30fc\u30b8\u306b\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><br><\/span><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u677e\u679c\u4f53\u816b\u760d\u306e2021\u5e74WHO\u5206\u985e<\/h4>\n\n\n\n<p><span style=\"color: #000080;\"><strong>1,<\/strong><strong> pineocytoma (WHO grade I)<br><\/strong><\/span><span style=\"color: #ff0000;\"><strong><span style=\"color: #000080;\">2. pineal parenchymal tumor of intermediate differentiation (WHO grade II or III)<\/span><br><\/strong><\/span><span style=\"color: #000080;\"><strong>3. pineoblastoma (WHO grade IV)<br><\/strong><\/span><strong><span style=\"color: #000080;\">4. Papillary tumors of the pineal region (\u30b0\u30ec\u30fc\u30c9 2, 3)<br><\/span><\/strong><span style=\"color: #000080;\"><strong>5. Desmoplastic myxoid tumor of the pineal region, <em>SMARKB1<\/em>-mutant<\/strong><\/span><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h1 class=\"wp-block-heading\">\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d pineal parenchymal tumors<\/h1>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306f\u3068\u3066\u3082\u73cd\u3057\u304f\u3066\u3001\u5927\u304d\u306a\u5927\u5b66\u75c5\u9662\u3067\u3082\u6570\u5e74\u306b\uff11\u4f8b\u304f\u3089\u3044\u3068\u3044\u3046\u983b\u5ea6\u3067\u3059<\/li>\n\n\n\n<li>\u3067\u3059\u304b\u3089\u3001\u3053\u306e\u816b\u760d\u306b\u8a73\u3057\u3044\u533b\u5e2b\u3068\u3044\u3046\u306e\u306f\u307b\u3068\u3093\u3069\u3044\u306a\u3044\u3068\u8003\u3048\u3066\u4e0b\u3055\u3044<\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u82bd\u816b\u306f\u5c0f\u5150\u306e\u816b\u760d\u3067\u3059<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000000;\">\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d<\/span>\u306b\u306f\u4e3b\u306a3\u3064\u306e\u816b\u760d\u304c\u3042\u308a\u307e\u3059<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\n<ul class=\"wp-block-list\">\n<li><span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u7d30\u80de\u816b &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;\u30b0\u30ec\u30fc\u30c91<\/strong><\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d PPTID &nbsp; \u30b0\u30ec\u30fc\u30c92\u304b3<\/strong><\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u82bd\u816b\u3000 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;\u30b0\u30ec\u30fc\u30c94<\/strong><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading style1\"><span style=\"color: #ff0000;\">\u677e\u679c\u4f53\u7d30\u80de\u816b pineocytoma WHO grade 1<\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u82e5\u3044\u6210\u4eba\u306b\u591a\u3044\u826f\u6027\u816b\u760d\u3067\u3059<\/li>\n\n\n\n<li>\u6c34\u982d\u75c7\u3067\u767a\u75c7\u3057\u307e\u3059\u304b\u3089\uff0c\u982d\u75db\u3068\u5614\u5410\u304c\u4e3b\u75c7\u72b6\u3067\u3059<\/li>\n\n\n\n<li>\u3067\u3082\u6700\u8fd1\u306f\u7121\u75c7\u72b6\u3067\u5076\u7136MRI\u3067\u307f\u3064\u304b\u308b\u3082\u306e\u304c\u591a\u304f\u306a\u3063\u3066\u304d\u307e\u3057\u305f<\/li>\n\n\n\n<li>MRI\u3067\u306f\u6955\u5186\u5f62\u306b\u898b\u3048\u3066\uff0c\u5883\u754c\u304c\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u306e\u3046\u80de\u6027\uff08\u4e2d\u306b\u6db2\u4f53\u304c\u5165\u3063\u3066\u3044\u308b\uff09\u306e\u3082\u306e\u3082\u5145\u5b9f\u6027\u306e\u3082\u306e\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u624b\u8853\u3067\u5168\u6458\u51fa\u3059\u308c\u3070\u6cbb\u7652\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u6709\u52b9\u306a\u306e\u3067\u3059\u304c\u300130-40%\u3067\u518d\u767a\uff08\u518d\u71c3\uff09\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306a\u3069\u306e\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u3067\u308220%\u307b\u3069\u306f\u518d\u71c3\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u518d\u71c3\u3059\u308b\u3068\u518d\u624b\u8853\u3067\u3059\u304c\u3001\u7652\u7740\u306e\u305f\u3081\u306b\u5168\u6458\u51fa\u3067\u304d\u305a\u3001\u6cbb\u308b\u898b\u8fbc\u307f\u306f\u4f4e\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u9006\u306b\u8a00\u3048\u3070\uff0c\u521d\u56de\u624b\u8853\u5168\u6458\u3057\u306a\u3044\u3068\u6cbb\u3089\u306a\u3044\u306e\u3067\u4f55\u3068\u3057\u3066\u3082\u6458\u51fa\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u3067\u3082\u624b\u8853\u306f\u7c21\u5358\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u7279\u306b\uff0c\u773c\u7403\u904b\u52d5\u969c\u5bb3\uff08\u8907\u8996\uff0c2\u91cd\u306b\u898b\u3048\u308b\uff09\u3068\u3044\u3046\u5f8c\u907a\u75c7\u3092\u51fa\u3055\u306a\u3044\u3053\u3068\u304c\u5927\u5207\u3067\u3059<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt2ax4.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt2ax4-200x200.jpg\" alt=\"\" class=\"wp-image-3155\" title=\"pineoTCt2ax\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt2ax4-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt2ax4-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt2ax4-550x547.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt2ax4.jpg 727w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1ceax1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1ceax1-200x200.jpg\" alt=\"\" class=\"wp-image-3156\" title=\"pineoTCt1ceax\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1ceax1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1ceax1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1ceax1-550x548.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1ceax1.jpg 700w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1sag1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineoTCt1sag1-200x200.jpg\" alt=\"\" class=\"wp-image-3157\" title=\"pineoTCt1sag\"\/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>\u6210\u4eba\u5973\u6027\u306e\u677e\u679c\u4f53\u7d30\u80de\u816b\u3067\u5145\u5b9f\u6027\u816b\u760d\u3067\u3059\u3002\u4e2d\u8133\u6c34\u9053\u304c\u9589\u585e\u3057\u3066\u8efd\u5ea6\u306e\u6c34\u982d\u75c7\uff08\u982d\u306e\u4e2d\u306b\u9ac4\u6db2\u304c\u6e9c\u307e\u308b\uff09\u306b\u306a\u3063\u3066\u304d\u3066\u3044\u307e\u3059\u3002\u591a\u5c11\u51f9\u51f8\u304c\u3042\u308a\u307e\u3059\u304c\u3060\u3044\u305f\u3044\u6955\u5186\u5f62\u3002<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">\u3082\u3057\u7121\u75c7\u72b6\u3067\u898b\u3064\u304b\u3063\u305f\u3089<\/h5>\n\n\n\n<p>\u677e\u679c\u4f53\u816b\u760d\u306e\u624b\u8853\u30ea\u30b9\u30af\u306f\u9ad8\u3044\u306e\u3067\uff0c\u7c21\u5358\u306b\u306f\u624b\u8853\u3092\u52e7\u3081\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u305b\u3093\u3002\u3067\u3082\u4e2d\u8133\u6c34\u9053\u306e\u72ed\u7a84\u304c\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u3066\u9589\u585e\u306e\u6050\u308c\u304c\u3042\u308b\u6642\u306b\u306f\u624b\u8853\u6458\u51fa\u3092\u3057\u305f\u307b\u3046\u304c\u3044\u3044\u3067\u3057\u3087\u3046\u3002\u79c1\u3082\u904e\u53bb\u306b\u3001\u60a3\u8005\u3055\u3093\u306b\u624b\u8853\u3092\u5f37\u304f\u52e7\u3081\u3089\u308c\u306a\u3044\u305f\u3081\u306b\u7d4c\u904e\u89b3\u5bdf\u3057\u3066\uff0c\u3064\u3089\u3044\u601d\u3044\u3092\u3057\u305f\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u4e2d\u8133\u6c34\u9053\u304c\u6025\u306b\u9589\u585e\u3059\u308b\u3068\uff0c\u6025\u6027\u6c34\u982d\u75c7\u3068\u306a\u308a\u3072\u3069\u3044\u982d\u75db\u304b\u3089\u610f\u8b58\u969c\u5bb3\u306b\u306a\u3063\u3066\uff0c1\u65e5\u3082\u305f\u306a\u3044\u3067\u7a81\u7136\u547c\u5438\u304c\u505c\u6b62\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u7121\u75c7\u72b6\u3067\u4f55\u5e74\u3082\u7d4c\u904e\u3057\u3066\uff0c\u6025\u6fc0\u306a\u6b7b\u306b\u81f3\u308b\u4f8b\u304c\u3042\u308b\u306e\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><a title=\"\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306e\u75c7\u4f8b pineal parenchymal tumor\" href=\"\/sawamura\/braintumors\/pinealparenchymaltumor\/\">\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u4f8b\u3092\u3082\u3063\u3068\u898b\u305f\u3044\u65b9\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u4e0b\u3055\u3044<\/a><\/strong><\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u75c5\u7406\u6240\u898b<\/strong><\/span><\/h4>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"232\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineohe2-300x232.jpg\" alt=\"\" class=\"wp-image-3113\" title=\"pineocytomatousrosette\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineohe2-300x232.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineohe2-550x427.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineohe2.jpg 846w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<\/div>\n\n\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pineohe2.jpg\">P<\/a>ineocytomatous rosettes with nucleus-free spaces&nbsp;mature neoplastic pineocytes.<br>\u816b\u760d\u7d30\u80de\u6838\u306e\u914d\u5217\u3067\u6838\u304c\u306a\u3044\u9699\u9593\u304c\u3067\u304d\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u4e2d\u306b\u306f\u816b\u760d\u7d30\u80de\u306e\u7a81\u8d77\u304c\u7d30\u304b\u3044\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u3092\u4f5c\u3063\u3066\u3044\u307e\u3059\u3002<br>\u6838\u306f\u67d3\u8272\u8cea\u306b\u5bcc\u3093\u3067\u3044\u307e\u3059\u304c\uff0c\u67d3\u8272\u8cea\u306e\u5206\u5e03\u306f\u4e0d\u6574\u3067\u3059\u3002\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306b\u5171\u901a\u3059\u308b\u3082\u306e\u3067\u3059\u304c\uff0csynaptophysin\u3068neuron-specific enolase\u304c\u967d\u6027\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong style=\"color: #000080;\">\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u3042\u308b\u6587\u732e<\/strong><\/h4>\n\n\n\n<p>Deshmukh&nbsp; VR: Diagnosis and management of pineocytomas. Neurosurgery 2004 \uff08\u7c73\u56fd\u306e\u5927\u304d\u306a\u8133\u5916\u79d1\u65bd\u8a2d\u304b\u3089\u306e\u5831\u544a\u3067\u3059\uff09<br>1990\u5e74\u4ee5\u964d\u306b\u6cbb\u7642\u3055\u308c\u305f\uff19\u4f8b\u306e\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u6cbb\u7642\u7d50\u679c\u3067\u3059\u3002\u5e73\u5747\u5e74\u9f62\u306f44\u6b73\u3067\u3059\u3002\uff13\u4f8b\u3067\u5168\u6458\u51fa\uff0c\uff16\u4f8b\u3067\u90e8\u5206\u6458\u51fa\u304b\u751f\u691c\u8853\u304c\u3055\u308c\u307e\u3057\u305f\u3002\uff13\u4f8b\u3067\u6b8b\u5b58\u816b\u760d\u306e\u518d\u767a\u304c\u3042\u308a\uff0c\u518d\u624b\u8853\u306b\u306a\u308a\u307e\u3057\u305f\u3002\uff11\u4f8b\u3067\u7b2c\uff14\u8133\u5ba4\u306e\u4e0b\u7aef(ovex)\u306b\u8ee2\u79fb\u518d\u767a\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u518d\u767a\u307e\u3067\u306e\u671f\u9593\u306f3.5\u5e74\u3067\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u518d\u767a\u3042\u308b\u3044\u306f\u8853\u5f8c\u306e\u6b8b\u5b58\u816b\u760d\u306e\u305f\u3081\u306b\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306a\u3069\u306e\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u3092\u53d7\u3051\u305f\uff17\u75c7\u4f8b\u3067\u306f\uff0c\u816b\u760d\u306e\u5927\u304d\u3055\u304c\u5909\u308f\u3089\u306a\u3044\u304b\u5c11\u3057\u7e2e\u5c0f\u3057\u305f\u3068\u3044\u3046\u7d50\u679c\u3067\u3059\u3002<br>\u89e3\u8aac\uff1a\uff19\u4f8b\u4e2d\u3067\uff13\u4f8b\u3057\u304b\u5168\u6458\u51fa\u3067\u304d\u3066\u3044\u307e\u305b\u3093\u3002\u3053\u306e\u6709\u540d\u306a\u65bd\u8a2d\u3067\u3082\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u5168\u6458\u51fa\u306e\u7387\u306f\u3068\u3066\u3082\u4f4e\u3044\u3067\u3059\u3002\u307e\u305f\uff0c\u5168\u6458\u3067\u304d\u305f\uff12\u4f8b\u306b\u3082\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3055\u308c\u3066\u3044\u3066\uff0c\u5fc5\u8981\u306a\u304b\u3063\u305f\u306e\u3067\u306f\u306a\u3044\u304b\u3068\u601d\u308f\u308c\u307e\u3059\u3002\u3061\u306a\u307f\u306b\uff0c\u6fa4\u6751\u306e\u677e\u679c\u4f53\u816b\u760d\u958b\u982d\u624b\u885370\u4f8b\u7a0b\u306e\u7d4c\u9a13\u306e\u4e2d\u3067\uff0c\uff17\u4f8b (10%) \u304c\u677e\u679c\u4f53\u7d30\u80de\u816b\u3067\u3057\u305f\u3002\u5168\u4f8b\u3067\u5168\u6458\u51fa\u3067\u304d\u3066\u3044\u3066\uff0c\u8853\u5f8c\u306b\u65b0\u305f\u306a\u8907\u8996\u306a\u3069\u306e\u5f8c\u907a\u75c7\u306f\u51fa\u3066\u3044\u307e\u305b\u3093\u3002\u307e\u305f\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\uff11\u4f8b\u3082\u3057\u307e\u305b\u3093\u3067\u3057\u305f\u304c\uff0c\u5e78\u3044\u518d\u767a\u4f8b\u306f\u7d4c\u9a13\u3057\u3066\u3044\u307e\u305b\u3093\u3002\u3084\u306f\u308a\u57fa\u672c\u7684\u306b\u306f\u624b\u8853\u3067\u5168\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3057\u3087\u3046\u3002\u3067\u3082\u4e00\u822c\u7684\u306b\u306f\u96e3\u3057\u3044\u3057\u3001\u30ea\u30b9\u30af\u306f\u9ad8\u3044\u3067\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u6709\u52b9\u306a\u306e\u3067\u3059\u304c\u3001\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u518d\u767a\u4f8b\u306e\u5831\u544a\u4f8b\u3082\u591a\u3044\u3067\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading style1\"><span style=\"color: #ff0000;\">\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d &nbsp;<\/span><span style=\"color: #ff0000;\">PPTID \u30b0\u30ec\u30fc\u30c9 2\u304b3<br><\/span><span style=\"color: #ff0000;\">pineal parenchyma tumor of intermediate differentiation WHO grade 2 &#8211; 3&nbsp;<\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u5168\u3066\u306e\u5e74\u9f62\u5c64\u306b\u767a\u751f\u3057\u307e\u3059\uff08\u5e73\u574730\u4ee3\u5f8c\u534a\uff09<\/li>\n\n\n\n<li>\u30b0\u30ec\u30fc\u30c9\uff12\u304b\u30b0\u30ec\u30fc\u30c9\uff13\u3067\uff0c<strong><span style=\"color: #ff0000;\">\u3084\u3084\u60aa\u6027<\/span><\/strong>\u3068\u3044\u3046\u816b\u760d\u3067\u3059<\/li>\n\n\n\n<li>\u6c34\u982d\u75c7\u3067\u982d\u75db\uff0c\u5614\u5410\uff0c\u773c\u304c\u4e0a\u306e\u65b9\u3092\u5411\u304b\u306a\u3044\uff08\u30d1\u30ea\u30ce\u30fc\u75c7\u5019\uff09\u3068\u3044\u3046\u75c7\u72b6\u304c\u3067\u305f\u308a\uff0c\u3082\u306e\u304c\u4e8c\u91cd\u306b\u898b\u3048\u305f\u308a\uff08\u8907\u8996\uff09\u3067\u767a\u75c7\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u6955\u5186\u5f62\u3068\u3044\u3046\u3088\u308a\u306f\u3084\u3084\u30dc\u30b3\u30dc\u30b3\u3057\u305f\u5f62\u306b\u898b\u3048\u307e\u3059<\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u7d30\u80de\u816b\u3068\u306e\u9055\u3044\u306f\u75c5\u7406\u8a3a\u65ad\u3067\u306f\u3058\u3081\u3066\u89e3\u308b\u3053\u3068\u3082\u591a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u75c5\u7406\u6240\u898b\u3067\u306f\u6838\u306e\u7570\u578b\u6027 nuclear atypia \u3068\u3044\u3046\u306e\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u6838\u5206\u88c2\u80fd\u306fMIB-1\u67d3\u8272\u3067\u8a55\u4fa1\u3057\u307e\u3059\u304c\uff0c3-10%\u304f\u3089\u3044\u3067\u3059\uff0c\u3053\u306e\u5024\u304c\u9ad8\u3044\u65b9\u304c\u30b0\u30ec\u30fc\u30c9\uff13\u3067\u3059<\/li>\n\n\n\n<li>\u30b0\u30ec\u30fc\u30c92\u3067\u3042\u308c\u3070\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u30b0\u30ec\u30fc\u30c93\u3067\u677e\u679c\u4f53\u82bd\u816b\u306b\u8fd1\u3044\u3088\u3046\u306a\u75c5\u7406\u50cf\u304c\u3042\u308c\u3070\u8133\u810a\u9ac4\u7167\u5c04\u304c\u5fc5\u8981\u3067\u3059<\/li>\n\n\n\n<li>\u73fe\u5728\u3067\u306f\u6cbb\u7642\u6210\u7e3e\u306f\u826f\u304f\u3066\u9577\u671f\u751f\u5b58\u3067\u304d\u308b\u306e\u3067\u3059\u304c\uff0c\u75c5\u7406\u6240\u898b\u3067\u306e\u60aa\u6027\u5ea6\u3067\u304b\u306a\u308a\u306e\u958b\u304d\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrt2.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"295\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrt2-295x300.jpg\" alt=\"\" class=\"wp-image-3183\" title=\"pptidmrt2\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrt2-295x300.jpg 295w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrt2-550x559.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrt2.jpg 611w\" sizes=\"auto, (max-width: 295px) 100vw, 295px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrsag.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"298\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrsag-298x300.jpg\" alt=\"\" class=\"wp-image-3184\" title=\"pptidmrsag\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrsag-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrsag-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidmrsag.jpg 485w\" sizes=\"auto, (max-width: 298px) 100vw, 298px\" \/><\/a><\/figure>\n<\/div>\n\n\n<div><\/div>\n\n\n\n<p>\u6210\u4eba\u7537\u6027\u304c\u65e9\u671d\u306e\u982d\u75db\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u9589\u585e\u6027\u6c34\u982d\u75c7\u306b\u306a\u3063\u3066\u3044\u308b\u306e\u3067\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u304c\u884c\u306a\u308f\u308c\u3066\u304b\u3089\u7d39\u4ecb\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u3066\uff0c\u75c5\u7406\u304c PPTID \u30b0\u30ec\u30fc\u30c93\u3067\u3057\u305f\u306e\u3067\uff0c\u8133\u810a\u9ac4\u7167\u5c04 24Gy\/12fr \u3068\u816b\u760d\u5c40\u6240\u7167\u5c04 54Gy\/27fr \u3092\u3057\u307e\u3057\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong><a title=\"\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d pineal parenchymal tumor\" href=\"\/sawamura\/braintumors\/pinealparenchymaltumor\/\"><span style=\"color: #000080;\">\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d PPTID \u306e\u75c7\u4f8b\u3092\u3082\u3063\u3068\u898b\u305f\u3044\u65b9\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/span><\/a><\/strong><\/span><\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u5927\u4e8b\u306a\u3053\u3068<\/strong><\/h4>\n\n\n\n<p>\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306f\u60aa\u6027\u5ea6\u304c\u3042\u308b\u816b\u760d\u3067\uff0c\u30b0\u30ec\u30fc\u30c9\uff12\u304b\uff13\u3068\u3055\u308c\uff0c\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306e\u304a\u3088\u305d20%\u3092\u5360\u3081\u307e\u3059\u3002\uff15\u5e74\u751f\u5b58\u5272\u5408\u306f40-70%\u7a0b\u5ea6\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u30b0\u30ec\u30fc\u30c9\uff12\u304b\uff13\u304b\u306f\u3063\u304d\u308a\u3057\u306a\u3044\u5834\u5408\u3082\u3042\u308a\uff0c\u75c5\u7406\u50cf\u3067\u60aa\u6027\u5ea6\u3092\u5224\u5b9a\u3057\u3066\u614e\u91cd\u306b\u653e\u5c04\u7dda\u3084\u5316\u5b66\u7642\u6cd5\u306eintensity\uff08\u5f37\u3055\uff09\u3092\u60a3\u8005\u3055\u3093\u3054\u3068\u306b\u6c7a\u3081\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002MIB-1\u67d3\u8272\u7387\u304c\u9ad8\u3044\u3082\u306e\u306f\u64ad\u7a2e\u3001\u5c40\u6240\u518d\u767a\u304c\u9ad8\u3044\u3068\u3044\u3046\u50be\u5411\u304c\u3042\u308a\u307e\u3059\u3002\u75c5\u7406\u6240\u898b\u3067\u78ba\u5b9f\u306b\u677e\u679c\u4f53\u82bd\u816b\u3068\u3044\u3048\u308b\u90e8\u5206\u50cf\u304c\u3042\u308b\u5834\u5408 (pineocytoma\/pineoblastoma)\u306b\u306f\uff0c\u30b0\u30ec\u30fc\u30c94\u3068\u3057\u3066\u6cbb\u7642\u3057\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d PPTID \u306e\u75c5\u7406<\/strong><\/h4>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpath2.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"287\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpath2-300x287.jpg\" alt=\"\" class=\"wp-image-3174\" title=\"pptidpath2\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpath2-300x287.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpath2-550x526.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpath2.jpg 692w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpathohe1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"285\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpathohe1-300x285.jpg\" alt=\"\" class=\"wp-image-3176\" title=\"OLYMPUS DIGITAL CAMERA\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpathohe1-300x285.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpathohe1-550x523.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pptidpathohe1.jpg 821w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>Sheets or large lobules of uniform cells with moderate nulear atypia and low to moderate mitotic activity, transitions from rosette-bearing areas to diffuse, sheetlike growth, 2 &gt; mitoses (10HPFs), 3-10% MIB-1.<\/p>\n\n\n\n<p>\u677e\u679c\u4f53\u82bd\u816b\u3068\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u4e2d\u9593\u306b\u4f4d\u7f6e\u3059\u308b\u75c5\u7406\u50cf\u3067\u3059\u3002\u677e\u679c\u4f53\u7d30\u80de\u816b\u3088\u308a\u7d30\u80de\u5bc6\u5ea6\u304c\u9ad8\u304f\uff0c\u8efd\u5ea6\u304b\u3089\u4e2d\u7b49\u5ea6\u306e\u6838\u7570\u578b\u304c\u3042\u308a\uff0c\u5206\u88c2\u80fd\u304c\u4e2d\u7b49\u5ea6\u306b\u9ad8\u3044\u3068\u3055\u308c\u307e\u3059\u3002\u5de6\u306e\u5199\u771f\u306e\u3088\u3046\u306b\uff0c\u677e\u679c\u4f53\u7d30\u80de\u816b\u306b\u4f3c\u305frosette\u3092\u4f5c\u308a\u306a\u304c\u3089\u3082\u7d30\u80de\u5bc6\u5ea6\u304c\u9ad8\u304f\u3073\u307e\u3093\u6027\u306b\u7d30\u80de\u6838\u304c\u96c6\u7a4d\u3059\u308b\u90e8\u5206\u3082\u898b\u3089\u308c\u305f\u308a\uff0c\u53f3\u306e\u5199\u771f\u306e\u3088\u3046\u306b\u300c\u3054\u304f\u4e00\u90e8\u300d\u306b\u5de8\u7d30\u80de\u304c\u898b\u3089\u308c\u305f\u308a\u6838\u7570\u578b\u3092\u4f34\u3046\u7d30\u80de\u304c\u51fa\u73fe\u3057\u307e\u3059\u3002Homer Wright rosette\u3084ganglion cell\u306e\u51fa\u73fe\u3082\u3042\u308a\u307e\u3059\u3002\u30b0\u30ec\u30fc\u30c92\u3068\u30b0\u30ec\u30fc\u30c93\u3092\u5206\u3051\u308b\u57fa\u6e96\u306f\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u307e\u305b\u3093\u304c\uff0c\u5206\u88c2\u80fd\u3092\u57fa\u6e96\u306b\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002MIB-1\u304c 3 to 10%\u3059\u304b\u3089\uff0c8%\u304f\u3089\u3044\u3060\u3068\u30b0\u30ec\u30fc\u30c93\u3068\u306a\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u307e\u305f\u816b\u760d\u306e\u5927\u90e8\u5206\u304c\u677e\u679c\u4f53\u7d30\u80de\u816b\u306e\u6240\u898b\u3067\uff0c\u4e00\u90e8\u306b\u4e0a\u8a18\u306e\u3088\u3046\u306a\u6240\u898b\u306e\u3042\u308b\u3082\u306e\u306f\u30b0\u30ec\u30fc\u30c92\u3068\u3057\u307e\u3059\u3002\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u306f\uff0c\u30b0\u30ec\u30fc\u30c92\u30683\u306e\u5b9a\u7fa9\u306f\u975e\u5e38\u306bfazzy\u3067\u3042\u308b\u3053\u3068\u3067\u3059\u3002\u3053\u308c\u306b\u3088\u3063\u3066\u5c40\u6240\u7167\u5c04\u304b\u8133\u810a\u9ac4\u7167\u5c04\u3092\u9078\u629e\u3059\u308b\u3053\u3068\u306f\u3068\u3066\u3082\u5371\u967a\u306a\u306e\u3067\u3059\u304c (\u30fb\u30fb\uff1f)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d PPTID \u306e\u4e88\u5f8c<\/strong><\/h4>\n\n\n\n<p>2016\u5e74WHO\u306e\u5206\u985e\u306b\u3088\u308b\u3068\uff0c\u3053\u306e\u816b\u760d\u306f\u30b0\u30ec\u30fc\u30c92\u304b3\u304b\u306e\u3042\u3044\u307e\u3044\u306a\u3068\u3053\u308d\u306b\u5206\u985e\u3055\u308c\u307e\u3059\u304b\u3089\u4e88\u5f8c\u306b\u306f\u304b\u306a\u308a\u5e45\u304c\u3042\u308a\uff0c5\u5e74\u751f\u5b58\u5272\u5408\u306f30-74%\u7a0b\u5ea6\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002Jouvet\u306e\u8ad6\u6587\u3067\u306f\uff0c\u30b0\u30ec\u30fc\u30c93\u306b\u5165\u308b\u4e88\u5f8c\u304c\u60aa\u3044\u56e0\u5b50\u3068\u3057\u3066\uff0c\u6838\u5206\u88c2\u50cf\u304c\u591a\u3044 (mitotic index &gt; 6 per HPFs, MIB-1\u3068\u306f\u9055\u3046\u306e\u3067\u6ce8\u610f\uff01)\uff0c \u58ca\u6b7b\u306e\u5b58\u5728\uff0cneurofilament protein\u9670\u6027\u306a\u3069\u3092\u3042\u3052\u3066\u3044\u307e\u3059\u3002\u3057\u304b\u3057\u3001\u3053\u306e\u5b9a\u7fa9\u306b\u5f93\u3046\u3068\u4e2d\u9593\u578b\u3068\u677e\u679c\u4f53\u82bd\u816b\u3068\u306e\u9451\u5225\u304c\u304b\u306a\u308a\u96e3\u3057\u3044\u3082\u306e\u3068\u306a\u308a\uff0c\u73fe\u5b9f\u7684\u306b\u306f\u3053\u306e\u3088\u3046\u306a\u30b0\u30ec\u30fc\u30c93\u306e\u816b\u760d\u306f\uff0c\u677e\u679c\u4f53\u82bd\u816b\u3068\u540c\u69d8\u306a\u6cbb\u7642\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading style1\"><span style=\"color: #ff0000;\">\u677e\u679c\u4f53\u82bd\u816b pineoblastoma WHO grade 4<\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u975e\u5e38\u306b\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u672a\u5206\u5316\u80ce\u5150\u6027\u816b\u760d\u3067\u3059<\/li>\n\n\n\n<li>0\u6b73\u304b\u30894\u6b73\u306e\u5c0f\u5150\u306b\u591a\u3044\u816b\u760d\u3067\u3001\u5e74\u9f62\u4e2d\u592e\u5024\u306f5\u6b73\u304f\u3089\u3044<\/li>\n\n\n\n<li>\u82e5\u5e74\u6210\u4eba\u306e\u4f8b\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u7db2\u819c\u82bd\u7d30\u80de\u816b\u306b\u5408\u4f75\u3059\u308b\u306e\u3082\u306e\u306f\uff0c\u816b\u760d\u6291\u5236\u907a\u4f1d\u5b50 <i>RB1<\/i> or <i>DICER1<\/i>\u306e\u5909\u7570\u306b\u3088\u3063\u3066\u767a\u751f\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u5927\u591a\u6570\u306e\u4ed6\u306e\u3082\u306e\u306f\uff0cPB-miRNA1, PB-miRNA2, PB-RB1, PB-MYC\/FOXR2<\/li>\n\n\n\n<li>\u3053\u306e\u5185\u3002PB-RB1, PB-MYC\/FOXR2\u5909\u7570\u3092\u6709\u3059\u308b\u5e7c\u3044\u5b50\u4f9b\u306e\u751f\u547d\u4e88\u5f8c\u304c\u7279\u306b\u60aa\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u975e\u5e38\u306b\u65e9\u304f\u5897\u5927\u3057\u307e\u3059\uff0c\u9032\u884c\u304c\u65e9\u3044\u306e\u3067\u6cbb\u7642\u3092\u6025\u304c\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u6025\u901f\u306b\u9589\u585e\u6027\u6c34\u982d\u75c7\u306b\u306a\u308b\u306e\u3067\u50be\u7720\u306a\u3069\u306e\u610f\u8b58\u969c\u5bb3\u3067\u767a\u75c7\u3059\u308b\u60a3\u8005\u3055\u3093\u3082\u3044\u307e\u3059<\/li>\n\n\n\n<li>MRI\u753b\u50cf\u3067\u306f\u4e0d\u6574\u5f62\u306e\u5f62\u3092\u3057\u3066\u3044\u3066\uff0c\u5468\u56f2\u306b\u8db3\u3092\u4f38\u3070\u3059\u69d8\u306b\u4f38\u5c55\u3057\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u8133\u7d44\u7e54\u306e\u4e2d\u306b\u3082\u6d78\u6f64\u3057\u3066\u5165\u3063\u3066\u3044\u304d\u307e\u3059<\/li>\n\n\n\n<li>\u9ac4\u6db2\u64ad\u7a2e\u3068\u8a00\u3063\u3066\uff0c\u8133\u3068\u810a\u9ac4\u306e\u8868\u9762\u306b\u5e83\u304f\u8ee2\u79fb\u3059\u308b\u6027\u8cea\u3092\u6301\u3063\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u624b\u8853\u3067\u5b8c\u5168\u306b\u6458\u51fa\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u624b\u8853\u6458\u51fa\u3057\u305f\u65b9\u304c\u4e88\u5f8c\u304c\u826f\u3044\u3068\u8a00\u308f\u308c\u3066\u3044\u307e\u3059\u304c\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u624b\u8853\u5f8c\u306b\u306f\u5f37\u529b\u306a\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\u304c\u5fc5\u8981\u3067\u3059<\/li>\n\n\n\n<li>\u5316\u5b66\u7642\u6cd5\u306f\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u3092\u57fa\u5264\u3068\u3059\u308b\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3092\u4f7f\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u8133\u810a\u9ac4\u7167\u5c04\u3068\u5c40\u6240\u7167\u5c04\u304c\u5fc5\u8981\u3067\u3059<\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u90e8\u306b\u306f54-60\u30b0\u30ec\u30a4\u304f\u3089\u3044\u306e\u7dda\u91cf\u3092\u4f7f\u7528\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u4e73\u5e7c\u5150\u3068\u6210\u4eba\u4f8b\u3067\u306f\u304b\u306a\u308a\u751f\u547d\u4e88\u5f8c\u304c\u9055\u3044\u307e\u3059\u3001\u6210\u4eba\u3067\u306f\u6cbb\u308b\u78ba\u7387\u306f\u9ad8\u3044\u3068\u3082\u8a00\u3048\u307e\u3059<\/li>\n\n\n\n<li>4\u6b73\u672a\u6e80\u306e\u5c0f\u5150\u306e\u4e88\u5f8c\u306f\u4e0d\u826f\u3067\u30012020\u5e74\u6642\u70b9\u30675\u5e74\u751f\u5b58\u5272\u5408\u306f10-20%\u7a0b\u5ea6\u3067\u3059<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo7.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo7.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo8.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo8.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>\u6210\u4eba\u7537\u6027\u306e\u677e\u679c\u4f53\u82bd\u816b\u3067\u3059\u3002\u5de6\u306eCT\u3067\u306f\u767d\u304f\u898b\u3048\u308b\u77f3\u7070\u5316\u304c\u3042\u308a\u307e\u3059\u3002\u6c34\u982d\u75c7\u304c\u3042\u3063\u3066\u982d\u75db\u3068\u5614\u5410\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u53f3\u306eMRI\u3067\u306f\u816b\u760d\u306e\u5f62\u304c\u4e38\u304f\u306a\u304f\u3066\u5468\u56f2\u306e\u8133\u306b\u6d78\u6f64\u3057\u305f\u308a\u8133\u5ba4\u306e\u58c1\u306a\u3069\u306b\u3079\u3063\u3068\u308a\u5e83\u304c\u3063\u3066\u3044\u308b\u3088\u3046\u306b\u898b\u3048\u307e\u3059\u3002\u60aa\u6027\u816b\u760d\u306e\u7279\u5fb4\u7684\u306a\u50cf\u3067\uff0c\u958b\u982d\u624b\u8853\u3092\u3057\u3066\u3082\u6458\u51fa\u3067\u304d\u306a\u3044\u3053\u3068\u304c\u5224\u308a\u307e\u3059\u3002\u677e\u679c\u4f53\u82bd\u816b\u306f\u60aa\u6027\u5ea6\u304c\u9ad8\u304f\u3066\uff08WHO\u30b0\u30ec\u30fc\u30c9\uff14\uff09\uff0c\u810a\u9ac4\u306a\u3069\u306b\u64ad\u7a2e\u8ee2\u79fb\u3057\u305f\u308a\u3057\u307e\u3059\u3057\uff0c\u624b\u8853\u3060\u3051\u3067\u306f\u6cbb\u308a\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo9.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo9.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo10.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pineo10.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>\u816b\u760d\u306f\u5b9a\u4f4d\u8133\u624b\u8853\u3067\u751f\u691c\u3092\u3057\u307e\u3057\u305f\u3002\u6c34\u982d\u75c7\u306b\u5bfe\u3057\u3066\u306f\u5185\u8996\u93e1\u3067\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u3092\u884c\u306a\u3063\u3066\u75c7\u72b6\u3092\u6539\u5584\u3057\u307e\u3057\u305f\u3002\u5de6\u306eMRI\u3067\u6c34\u982d\u75c7\u304c\u826f\u304f\u306a\u3063\u3066\u3044\u308b\u306e\u304c\u5224\u308b\u3068\u601d\u3044\u307e\u3059\u3002\u305d\u308c\u304b\u3089\uff0c\u5168\u8133\u810a\u9ac4\u306b30\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\u816b\u760d\u5c40\u6240\u306b\u306f24\u30b0\u30ec\u30a4\u306e\u7167\u5c04\u3092\u8ffd\u52a0\u3057\u307e\u3057\u305f\u3002\u540c\u6642\u306b<a href=\"..\/pediattumor\/icechemothr\/\">ICE\u5316\u5b66\u7642\u6cd5<\/a>\u3068\u3044\u3046\u306e\u3092\uff16\u30b3\u30fc\u30b9\u3057\u307e\u3057\u305f\u3002\u53f3\u306eMRI\u3067\u306f\u6cbb\u7642\u304c\u7d42\u308f\u3063\u3066\u5c0f\u3055\u304f\u56fa\u307e\u3063\u305f\u6b8b\u5b58\u816b\u760d\u304c\u898b\u3048\u307e\u3059\u3002\u3053\u306e\u6b8b\u5b58\u816b\u760d\u306f\u7b2c\uff13\u8133\u5ba4\u306e\u58c1\u306b\u304f\u3063\u3064\u3044\u3066\u3044\u3066\u6458\u51fa\u3059\u308b\u30ea\u30b9\u30af\u304c\u3068\u3066\u3082\u9ad8\u3044\u3068\u601d\u3044\u307e\u3057\u305f\u306e\u3067\uff0c\u305d\u306e\u307e\u307e\u305a\u30fc\u3063\u306810\u5e74\u9593\u69d8\u5b50\u3092\u898b\u3066\u3044\u307e\u3059\u304c\u518d\u767a\u3057\u3066\u3044\u307e\u305b\u3093\u3002\u3067\u3082\uff0c\u6b8b\u5b58\u816b\u760d\u304c\u306a\u3093\u3068\u304b\u53d6\u308c\u308b\u6642\u306f\u5fb9\u5e95\u7684\u306b\u53d6\u3063\u3066\u3057\u307e\u3063\u305f\u65b9\u304c\u518d\u767a\u7387\u306f\u5c11\u306a\u3044\u3068\u3044\u3048\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u677e\u679c\u4f53\u82bd\u816b\u306e\u6cbb\u7642<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u307e\u305a\u3001<span style=\"color: #000080;\"><strong>\u4e73\u5e7c\u5150\u3068\u9752\u5e74\u6210\u4eba\u4f8b\u3067\u306f\u6cbb\u7642\u6210\u7e3e\u304c\u5168\u304f\u7570\u306a\u308b<\/strong><\/span>\u816b\u760d\u3060\u3068\u3044\u3046\u3053\u3068\u3092\u8a8d\u8b58\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u5168\u3066\u306e\u75c7\u4f8b\u3067\u6c34\u982d\u75c7\u3092\u5408\u4f75\u3059\u308b\u306e\u3067\uff0c\u5185\u8996\u93e1\u306b\u3088\u308b\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u3068\u751f\u691c\u8853\u3092\u884c\u306a\u3063\u3066\u3001\u75c7\u72b6\u306e\u6539\u5584\u3068\u75c5\u7406\u8a3a\u65ad\u3092\u78ba\u5b9a\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u3053\u306e\u816b\u760d\u306f\u51fa\u8840\u6027\u3067\u3059\u304b\u3089\u5185\u8996\u93e1\u751f\u691c\u6642\u306e\u51fa\u8840\u306e\u30ea\u30b9\u30af\u306f\u4f4e\u304f\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u5927\u304d\u306a\u3082\u306e\u3067\u306fCT\u30ac\u30a4\u30c9\u306e\u5b9a\u4f4d\u8133\u624b\u8853\u3082\u9078\u629e\u80a2\u3068\u3057\u3066\u3042\u3052\u3089\u308c\u307e\u3059<\/li>\n\n\n\n<li>\u8a3a\u65ad\u6642\u306e\u958b\u982d\u816b\u760d\u6458\u51fa\u8853\u306f\uff0c\u8133\u7d44\u7e54\u3078\u306e\u6d78\u6f64\u6027\u683c\u306b\u3088\u308a\u5168\u6458\u51fa\u304c\u3067\u304d\u306a\u3044\u3053\u3068\u3068\u3001\u51fa\u8840\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u306e\u3067\u304a\u52e7\u3081\u3067\u304d\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u3067\u3082\u8ee2\u79fb\u306e\u306a\u3044\u5e74\u9577\u5150\u3042\u308b\u3044\u306f\u6210\u4eba\u4f8b\u3067\u3042\u308c\u3070\u3001\u6700\u521d\u304b\u3089maximal safe resection\u3042\u308b\u3044\u306f\u5168\u6458\u51fa\u3092\u76ee\u6307\u3057\u305f\u307b\u3046\u304c\u3044\u3044\u3068\u3044\u3046\u610f\u898b\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u64ad\u7a2e\u6027\u683c\u3092\u6709\u3059\u308b\u80ce\u5150\u6027\u816b\u760d\u3067\u3059\u304b\u3089\u3001\u958b\u982d\u624b\u8853\u3067\u7d30\u80de\u3092\u9ac4\u6db2\u306e\u4e2d\u306b\u3070\u3089\u6492\u3044\u3066\u3057\u307e\u3046\u3068\u3044\u3046\u3001\u624b\u8853\u8a98\u767a\u64ad\u7a2e\u306e\u30ea\u30b9\u30af\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u6fa4\u6751\u306f\u751f\u691c\u8a3a\u65ad\u306e\u76f4\u5f8c\u306b\uff0c\u5316\u5b66\u7642\u6cd5\u3092\uff11\u30b3\u30fc\u30b9\u4f7f\u7528\u3057\u3066\u5316\u5b66\u7642\u6cd5\u53cd\u5fdc\u6027\u3092\u78ba\u304b\u3081\u3066\u304b\u3089\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3078\u79fb\u884c\u3057\u3066\u3044\u307e\u3057\u305f<\/li>\n\n\n\n<li>\u591a\u5264\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u304c\u8457\u52b9\u3059\u308b\u4f8b\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u5fc5\u9808\u3067\u3059<\/li>\n\n\n\n<li>\u5168\u8133\u810a\u9ac4\u7167\u5c04\u3068\u816b\u760d\u3078\u306e\u8ffd\u52a0\u5c40\u6240\u7167\u5c04\u3092\u539f\u5247\u3068\u3057\u307e\u3059\u3002\u816b\u760d\u7dda\u91cf\u306f54Gy\u304b\u308960Gy\u3067\u3059<\/li>\n\n\n\n<li>4\u6b73\u672a\u6e80\u3067\u306f\u8133\u810a\u9ac4\u7167\u5c04\u304c\u3067\u304d\u306a\u3044\u306e\u3067\u3001\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u5c40\u6240\u5546\u793e\u3067\u306e\u6cbb\u7642\u304c\u63d0\u6848\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u5e74\u9577\u5150\u3068\u6210\u4eba\u3067\u306f\u3001\u751f\u691c\u8853\u5f8c\u306b\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3092\uff11\u30b3\u30fc\u30b9\u884c\u3063\u3066\u5316\u5b66\u7642\u6cd5\u306e\u52b9\u679c\u3092\u78ba\u8a8d\u3057\u305f\u5f8c\u3067\uff0c\u5c40\u6240\u7167\u5c04\uff0c\u7d9a\u3044\u3066\u5168\u8133\u810a\u9ac4\u7167\u5c04\uff0c\u3055\u3089\u306b\u8ffd\u52a0\u306e\u5316\u5b66\u7642\u6cd5<\/strong><\/span>\u3092\u884c\u3046\u306e\u304c\u826f\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u816b\u760d\u306e\u5897\u5927\u3042\u308b\u3044\u306f\u64ad\u7a2e\u5897\u60aa\u306f\u65e9\u3044\u306e\u3067\uff0c\u6cbb\u7642\u306e\u958b\u59cb\u3068\u7d99\u7d9a\u306b\u306f\u6642\u9593\u7684\u306a\u4f59\u88d5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u5f53\u7136\u306e\u3053\u3068\u306a\u304c\u3089\u4e73\u5e7c\u5150\u3067\u306f\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u306e\u662f\u975e\u306f\u75c7\u4f8b\u6bce\u306b\u691c\u8a0e\u3055\u308c\u308b\u3079\u304d\u3067\uff0c\u4e21\u89aa\u3068\u306e\u5408\u610f\u306e\u3082\u3068\u306b\uff0c\u7dda\u91cf\u3084\u7167\u5c04\u91ce\u3092\u9010\u4e00\u9078\u629e\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u3067\u3055\u3089\u306b\u816b\u760d\u304c\u6b8b\u3063\u3066\u3044\u308c\u3070\u3001\u305d\u308c\u3092\u6458\u51fa\u3057\u3066\u3057\u307e\u3063\u305f\u307b\u3046\u304c\u518d\u767a\u5272\u5408\u304c\u6e1b\u308b\u3068\u3044\u3046\u610f\u898b\u304c\u3042\u308a\u307e\u3059 (second look surgery\uff09<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\">\u677e\u679c\u4f53\u816b\u760d\u3068\u9593\u9055\u3048\u3084\u3059\u3044\u816b\u760d<\/h5>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\">\u677e\u679c\u4f53\u90e8\u306e\u30b0\u30ea\u30aa\u30fc\u30de&nbsp;<\/span><\/h4>\n\n\n\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pinealastro.png\"><img loading=\"lazy\" decoding=\"async\" style=\"margin-left: 5px; margin-right: 5px;\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pinealastro.png\" alt=\"\" width=\"242\" height=\"250\" align=\"left\" hspace=\"5\"><\/a>\u82e5\u3044\u5973\u6027\u306b\u3067\u304d\u305f\u677e\u679c\u4f53\u90e8\u306e\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u3067\u3059\u3002\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u305f\u3060\u3051\u3067\u6cbb\u308a\u307e\u3057\u305f\u3002\u3053\u306e\u816b\u760d\u306f\u6b63\u78ba\u306b\u306f\u677e\u679c\u4f53\u816b\u760d\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u53f3\u306e\u8996\u5e8a\u3068\u3044\u3046\u3068\u3053\u308d\u304b\u3089\u767a\u751f\u3057\u3066\uff0c\u677e\u679c\u4f53\u90e8\u306b\u4f38\u3073\u3066\u5927\u304d\u304f\u306a\u308a\u4e00\u898b\u677e\u679c\u4f53\u816b\u760d\u306b\u307f\u3048\u308b\u3082\u306e\u3067\u3059\u3002\u3067\u3059\u304b\u3089\u6b63\u78ba\u306b\u306f\u8996\u5e8a\u816b\u760d\u306a\u306e\u3067\u3059\u3002\u3058\u3063\u304f\u308a\u6ce8\u610f\u3057\u3066\u307f\u308c\u3070\u5224\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\"><a title=\"\u9ac4\u819c\u816b\u306e\u75c7\u4f8b\u3068\u75c5\u7406\" href=\"\/sawamura\/casestudy\/meningcases\/\">\u677e\u679c\u4f53\u90e8\u306e\u9ac4<\/a><\/span><span style=\"color: #000080;\"><a title=\"\u9ac4\u819c\u816b\u306e\u75c7\u4f8b\u3068\u75c5\u7406\" href=\"\/sawamura\/casestudy\/meningcases\/\">\u819c\u816b\uff08\u5927\u8133\u938c\u30c6\u30f3\u30c8\u63a5\u5408\u90e8\u9ac4\u819c\u816b\uff09<\/a><\/span><\/h4>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/falcotentkh11.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"295\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/falcotentkh11-295x300.jpg\" alt=\"\" class=\"wp-image-4199\" title=\"falcotentkh1\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/falcotentkh11-295x300.jpg 295w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/falcotentkh11.jpg 546w\" sizes=\"auto, (max-width: 295px) 100vw, 295px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><br>30\u4ee3\u306e\u5973\u6027\u3067\u3059\u304b\u3089\uff0c\u677e\u679c\u4f53\u7d30\u80de\u816b\u306b\u898b\u3048\u307e\u3059\u3002\u3067\u3082\uff0c\u3053\u308c\u306f\u5927\u8133\u938c\u30c6\u30f3\u30c8\u63a5\u5408\u90e8\u304b\u3089\u767a\u751f\u3057\u305f\u9ac4\u819c\u816b\u3067\u3059\u3002<br>\u4e2d\u8133\u6c34\u9053\u72ed\u7a84\u3082\u8efd\u5ea6\u306e\u9589\u585e\u6027\u6c34\u982d\u75c7\u3082\u3042\u308a\uff0c\u677e\u679c\u4f53\u816b\u760d\u3068\u533a\u5225\u306f\u96e3\u3057\u3044\u3068\u601d\u3063\u3066\u3057\u307e\u3046\u3082\u306e\u3067\u3059\u304c\uff0c\u9451\u5225\u3067\u304d\u307e\u3059\u3002\u307e\u305f\u624b\u8853\u306f\u677e\u679c\u4f53\u7d30\u80de\u816b\u3088\u308a\u7c21\u5358\u3067\u3059\u3002<br><a title=\"\u9ac4\u819c\u816b\u306e\u75c7\u4f8b\u3068\u75c5\u7406\" href=\"\/sawamura\/casestudy\/meningcases\/\">\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u3082\u3063\u3068\u8a73\u3057\u304f\u898b\u308c\u307e\u3059\uff09&nbsp;<\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"style1\" style=\"color: #000080;\">PTPR papillary tumor of the pineal region WHO grade 2 or 3<\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u3068\u3066\u3082\u7a00\u306a<strong><span style=\"color: #000080;\">\u6210\u4eba\uff08\u5e73\u574732\u6b73\uff09\u306e\u816b\u760d\u3067\uff0c<\/span><span style=\"color: #000080;\">\u30b0\u30ec\u30fc\u30c92\u304b3<\/span><\/strong>\u3067\u3059<\/li>\n\n\n\n<li>\u8d77\u6e90\u306f\uff0cependymal cells of the subcommissural organ \u3068\u63a8\u5b9a\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u6210\u4eba\u5973\u6027\u3067\u306e\u5831\u544a\u4f8b\u304c\u591a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u5927\u304d\u306a\u816b\u760d\u3067\u9589\u585e\u6027\u6c34\u982d\u75c7\u3068\u306a\u308a\uff0c\u982d\u75db\u3067\u767a\u75c7\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u6bd4\u8f03\u7684\u306b\u5883\u754c\u660e\u77ad\u306a\u677e\u679c\u4f53\u90e8\u816b\u760d\u3067\u3059<\/li>\n\n\n\n<li>\u753b\u50cf\u306f\u677e\u679c\u4f53\u7d30\u80de\u816b WHO grade 1\u3068\u307b\u3068\u3093\u3069\u898b\u5206\u3051\u304c\u3064\u304d\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u624b\u8853\u6458\u51fa\u3060\u3051\u3067\u306f\u518d\u767a\u7387\u304c\u9ad8\u304f\uff0c\u3054\u304f\u307e\u308c\u306b\u64ad\u7a2e\u3059\u308b\u3053\u3068\u3082\u3042\u308b\u3088\u3046\u3067\u3059<\/li>\n\n\n\n<li>\u81e8\u5e8a\u50cf\u306f\u4e0a\u8863\u816b\u3068\u985e\u4f3c\u3059\u308b\u3088\u3046\u3067\uff0c<span style=\"color: #000080;\"><strong>\u60aa\u6027\u816b\u760d\u3068\u6349\u3048\u305f\u65b9\u304c\u3088\u3044\u3067\u3057\u3087\u3046<\/strong><\/span><\/li>\n\n\n\n<li>\u6cbb\u7642\u306f<strong><span style=\"color: #000080;\">\u6458\u51fa\u8853\u3068<\/span><span style=\"color: #000080;\">\u8853\u5f8c\u306e\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642<\/span><\/strong>\u304c\u5fc5\u8981\u3068\u3055\u308c\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>5\u5e74\u751f\u5b58\u5272\u5408\u306f70\uff05\u307b\u3069\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u75c5\u7406\u50cf\u306f\u4ee5\u4e0b\u306e\u3088\u3046\u306b\u8a18\u8ff0\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>Microscopically, these neoplasms demonstrated diffuse cellular proliferation with large areas demonstrating papillary features and well-formed glands. The cellular structures demonstrate cells that have a moderate amount of eosinophilic cytoplasm and mildly nonuniform round-to-oval nuclei with a prominent basophilic nucleolus. Signet ring cells may be present. Moderate mitotic figures were notable. Immunohistochemical studies demonstrated dramatic immunoreaction in the PTPR neoplastic cells against cytokeratin, S-100 protein, NSE, and vimentin, whereas the PTPR neoplastic cells were not immunoreactive for synaptophysin and had variable staining for EMA. Among the more common differential diagnoses to consider is papillary ependymoma. The cellular structure of PTPR shows them to be less papillary than CPP but significantly more differentiated than would be expected for choroid plexus carcinoma.. \u75c5\u7406\u8a3a\u65ad\u3067\u8ee2\u79fb\u6027\u817a\u764c\u3068\u8aa4\u8a3a\u3055\u308c\u308b\u3053\u3068\u304c\u3042\u308b\u3088\u3046\u3067\u3059\u3002<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Dagnew E, et al.: Papillary tumors of the pineal region: case report. Neurosurgery 60: 953-955, 2007<\/li>\n\n\n\n<li>Kern M. et al.: Papillary tumor of the pineal region &#8211; a new pathological entity. Clin Neuropathol 25: 185-192, 2006<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong>Desmoplastic myxoid tumor of the pineal region, <em>SMARKB1<\/em>-mutant<\/strong><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u601d\u6625\u671f\u304b\u3089\u6210\u4eba\u306b\u307f\u3089\u308c\u308b\u816b\u760d\u3067\u3059\uff0c\u4e2d\u592e\u5024\u306f40\u4ee3\u304f\u3089\u3044<\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u7d44\u7e54\u69cb\u7bc9\u306fdesmoplasia\u3068\u7c98\u6db2\u72b6\u5909\u6027\u3092\u7279\u5fb4\u3068\u3057\uff0cspindle cell\u3068\u985e\u4e0a\u76ae\u69d8\u7d30\u80de\u304c\u307f\u3089\u308c\u307e\u3059<\/li>\n\n\n\n<li>\u7d44\u7e54\u50cf\u304b\u3089\u306f\u672a\u5206\u5316\u306a\u810a\u7d22\u816b\u306e\u3088\u3046\u307f\u3082\u898b\u3048\u308b\u3082\u306e\u3067\u3059<\/li>\n\n\n\n<li>INI1\u6b20\u5931\u3068SMARKB-1\u907a\u4f1d\u5b50\u5909\u7570\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>MIB-1\u67d3\u8272\u7387\u306f3%\u7a0b\u5ea6\u3068\u4f4e\u304f\uff0c\u5897\u6b96\u306f\u9045\u3044\u306e\u3067\u826f\u6027\u306e\u7d4c\u904e\u3092\u305f\u3069\u308b\u3082\u306e\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u6cbb\u7652\u3059\u308b\u3082\u306e\u304b\u3089\u6fc0\u3057\u3044\u5897\u6b96\u3092\u793a\u3059\u3082\u306e\u307e\u3067\u3042\u308a\u591a\u6570\u4f8b\u3067\u306e\u9577\u671f\u4e88\u5f8c\u306f\u5224\u7136\u3068\u3057\u307e\u305b\u3093\uff0cThomas\u306f7\u4f8b\u4e2d3\u4f8b\u304c\u4ea1\u304f\u306a\u3063\u305f\u3068\u5831\u544a\u3057\u3066\u3044\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<p class=\"heading-title\">1. &nbsp;Thomas C: Desmoplastic myxoid tumor, SMARCB1-mutant: clinical, histopathological and molecular characterization of a pineal region tumor encountered in adolescents and adults. Acta Neuropathol, 2020<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span style=\"color: #000080;\">trilateral retinoblastoma<\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u4e73\u5e7c\u5150\u306b\u767a\u751f\u3059\u308b\u816b\u760d\u3067\u3059<\/li>\n\n\n\n<li><span style=\"color: #ff0000;\"><strong>\u4e21\u773c\uff08\u7247\u5074\u306e\u3053\u3068\u3082\u3042\u308a\uff09\u306b\u7db2\u819c\u82bd\u7d30\u80de\u816b<\/strong><\/span> retinoblastoma\u304c\u3067\u304d\u3066\uff0c\u306a\u304a\u304b\u3064\u982d\u306e\u4e2d\u5fc3\u90e8\uff08<span style=\"color: #ff0000;\"><strong>\u677e\u679c\u4f53\u304b\u978d\u4e0a\u90e8<\/strong><\/span>\uff09\u306b\u80ce\u5150\u6027\u816b\u760d\u304c\u3067\u304d\u308b\u60aa\u6027\u306e\u75be\u60a3\u3067\u3059<\/li>\n\n\n\n<li>\u591a\u304f\u306f<strong><span style=\"color: #ff0000;\">\u795e\u7d4c\u82bd\u7d30\u80de\u816b<\/span><\/strong>&nbsp;neuroblastic tumor (<span style=\"color: #ff0000;\"><strong>\u677e\u679c\u4f53\u82bd\u816b<\/strong><\/span>&nbsp;pineoblastoma ) \u3092\u5408\u4f75\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u901a\u5e38\u306f\u7db2\u819c\u82bd\u7d30\u80de\u816b\u304c\u767a\u898b\u3055\u308c\u3066\uff0c\u305d\u306e\u5f8c\uff08\u6570\u30f6\u6708\u3068\u304b\u6570\u5e74\u3068\u304b\uff09\u306b\u677e\u679c\u4f53\u816b\u760d\u304c\u3067\u304d\u307e\u3059<\/li>\n\n\n\n<li>\u4e21\u5074\u306e\u7db2\u819c\u82bd\u7d30\u80de\u816b\u306e5%\u307b\u3069\u306b\u3001\u677e\u679c\u4f53\u82bd\u816b\u304c\u767a\u751f\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u677e\u679c\u4f53\u816b\u760d\u304c\u306a\u3044\u304b\u3069\u3046\u304b\u3092\u8abf\u3079\u3066\uff0c\u5c0f\u3055\u3044\u3046\u3061\u306b\u65e9\u3081\u306b\u767a\u898b\u3057\u3066\u6cbb\u7642\u3059\u308c\u3070\u6cbb\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u9ad8\u7387\u306b\u9ac4\u6db2\u64ad\u7a2e\u8ee2\u79fb\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u6cbb\u7642\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u4f7f\u7528\u3067\u304d\u306a\u3044\u4f8b\u3067\u306f\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u672b\u68a2\u8840\u5e79\u7d30\u80de\u79fb\u690d\u3067\u3059<\/li>\n\n\n\n<li>5\u5e74\u751f\u5b58\u5272\u5408\u306f40%\u307b\u3069\u3067\u3059<\/li>\n\n\n\n<li>\u3067\u3082\u5927\u304d\u306a\u677e\u679c\u4f53\u82bd\u816b\u306b\u306a\u3063\u3066\u3057\u307e\u3046\u30685\u5e74\u751f\u5b58\u5272\u5408\u306f10%\u4ee5\u4e0b\u3067\u3059<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\">\u677e\u679c\u4f53\u816b\u760d\u306e\u624b\u8853\u6cd5\u306e\u5909\u9077<\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u3053\u306e100\u5e74\u9593\u306b\u69d8\u3005\u306a\u5916\u79d1\u624b\u8853\u6cd5\u304c\u958b\u767a\u3055\u308c\u767a\u5c55\u3057\u307e\u3057\u305f<\/li>\n\n\n\n<li>20\u4e16\u7d00\u521d\u982d\u3001Dandy\u306fparietal parasagittal transcallosal approach\u3092\u7528\u3044\uff0cVan Wagenen\u306ftransventricular approach\u3092\u5831\u544a\u307e\u3057\u305f\u304c\uff0c\u5f7c\u3089\u306e\u6642\u4ee3\u306b\u304a\u3044\u3066\u306e\u624b\u8853\u6b7b\u4ea1\u7387\u306f\uff0c\u975e\u5e38\u306b\u9ad8\u3044\u3082\u306e\u3067\u3057\u305f<\/li>\n\n\n\n<li>1920\u5e74\u306bKrause\u306f\uff0cinfratentorial supracerebellar approach\u3092\u7528\u3044\u3066\uff0c\uff13\u624b\u8853\u6210\u529f\u4f8b\u3092\u767a\u8868\u3057\u3001Stein\u304c1970\u5e74\u4ee3\u306b\u3053\u306e\u624b\u6cd5\u3092\u78ba\u7acb\u3055\u305b\u305f\u3053\u3068\u3067\u6709\u540d\u3067\u3059<\/li>\n\n\n\n<li>1960\u5e74\u4ee3\u306b\u306a\u308a\uff0cPoppen\u304csuboccipital approach\u3092\u958b\u767a\u3057\uff0c\u305d\u306e\u5f8cJamieson\u304c\u73fe\u5728\u6c4e\u7528\u3055\u308c\u3066\u3044\u308boccipital interhemispheric transtentorial approach\u306b\u307e\u3067\u767a\u5c55\u3055\u305b\u307e\u3057\u305f<\/li>\n\n\n\n<li>\u3053\u306e\u7d4c\u30c6\u30f3\u30c8\u6cd5 OTA occipital interhemispheric transtentorial approach\u304c\uff0c\u73fe\u5728\u306f\u6a19\u6e96\u7684\u306a\u624b\u8853\u5230\u9054\u6cd5\u3067\u3059<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\"><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/contact_yamamoto\/\">\u677e\u679c\u4f53\u816b\u760d\u306b\u95a2\u3057\u3066\uff0c\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u306e\u5c71\u672c\u54f2\u54c9\u304c\u5fa1\u76f8\u8ac7\u306b\u306e\u308a\u307e\u3059\uff0c\u30e1\u30fc\u30eb\u3092\u9001\u308a\u305f\u3044\u65b9\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u304f\u3060\u3055\u3044<\/a><\/span><\/h5>\n\n\n\n<h5 class=\"wp-block-heading\">\u6587\u732e\u60c5\u5831<\/h5>\n\n\n\n<div class=\"article-citation\">\n<h4>\u4e2d\u9593\u578b\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306e\u6cbb\u7642\u6210\u7e3e<\/h4>\n<\/div>\n\n\n\n<p class=\"heading-title\"><span class=\"authors-list-item \">Choque-Velasquez J:&nbsp;<\/span>Pineal Parenchymal Tumors of Intermediate Differentiation: A long-Term Follow-Up Study in Helsinki Neurosurgery. World Neurosurg 2019<br>\u30ce\u30eb\u30a6\u30a7\u30fc\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u300215\u4f8b\u304c\u3001\u7a4d\u6975\u7684\u306a\u624b\u8853\u6458\u51fa\u3068\u75c5\u7406\u6240\u898b\u306b\u5fdc\u3058\u305f\u653e\u5c04\u7dda\u6cbb\u7642 (9\u4f8b)\u3067\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u300210\u5e74\u307b\u3069\u306e\u8ffd\u8de1\u671f\u9593\u3067\u751f\u5b58\u5272\u5408\u306f57%\u3067\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u3078\u306e\u653e\u5c04\u7dda\u6cbb\u7642<\/h4>\n\n\n\n<p>Kumer N: Role of radiotherapy in residual pineal parenchymal tumors. Clin Neurol Neurusurg 2018<br>2006\u5e74\u304b\u308916\u5e74\u306b\u3001\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d14\u4f8b\u306b\u624b\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642 45-54Gy \u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u300212\u4f8b\u3067\u306f3D-conformal\u3067\u3059\u30028\u4f8b\u304c\u30b0\u30ec\u30fc\u30c91\u306e\u6d88\u5316\u4f53\u7d30\u80de\u816b\u30014\u4f8b\u304cPPTID\u30012\u4f8b\u304c\u30b0\u30ec\u30fc\u30c94\u306e\u677e\u679c\u4f53\u82bd\u816b\u3067\u3057\u305f\u3002\u8133\u810a\u9ac4\u7167\u5c04\u306f2\u4f8b\u306b\u884c\u308f\u308c\u307e\u3057\u305f\u30023\u4f8b\u306e\u6d88\u5316\u4f53\u7d30\u80de\u816b\u30682\u4f8b\u306e\u677e\u679c\u4f53\u82bd\u816b\u3067\u518d\u767a\u304c\u3042\u308a\u30012\u4f8b\u306e\u677e\u679c\u4f53\u7d30\u80de\u816b\u30682\u4f8b\u306e\u677e\u679c\u4f53\u82bd\u816b\u304c\u6b7b\u4ea1\u3057\u307e\u3057\u305f\u3002<br>\u300c\u89e3\u8aac\u300d\u6458\u51fa\u3059\u308c\u3070\u6cbb\u308b\u30b0\u30ec\u30fc\u30c9 1\u306e\u677e\u679c\u4f53\u7d30\u80de\u816b\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u4f9d\u5b58\u306e\u6cbb\u7642\u3092\u3057\u3066\u30012\u4f8b\u3092\u5931\u3063\u3066\u3044\u307e\u3059\u3002\u9006\u306b\u3001\u677e\u679c\u4f53\u7d30\u80de\u816b pineocytoma\u306f\u30013D-conformal RT\u3067\u306f\u9ad8\u7387\u306b\u518d\u71c3\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u304c\u8a00\u3048\u307e\u3059\u3002\u624b\u8853\u3067\u5168\u6458\u51fa\u3059\u308b\u3079\u304d\u816b\u760d\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"docsum-authors full-authors\">\u6b27\u7c73\u3067\u306e\u591a\u6570\u4f8b\u306e\u89e3\u6790<\/span><\/h4>\n\n\n\n<p><span class=\"docsum-authors full-authors\">Mynarek M:&nbsp;<\/span>Evaluation of age-dependent treatment strategies for children and young adults with pineoblastoma: analysis of pooled European Society for Paediatric Oncology (SIOP-E) and US Head Start data. Neuro Oncol 2017<br>\u30e8\u30fc\u30ed\u30c3\u30d1\u3068\u7c73\u5dde\u3067\u6cbb\u7642\u3092\u53d7\u3051\u305f153\u4f8b\u306e\u5831\u544a\u3067\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u5024\u306f4.9\u6b73\u3067\u3059\u30024\u6b73\u672a\u6e8057\u4f8b\u306e5\u5e74\u751f\u5b58\u5272\u5408 PFS\/OS\u306f\u300110\uff05\u5f37\u7a0b\u5ea6\u3068\u6975\u3081\u3066\u4e0d\u826f\u3067\u3057\u305f\u30029\u5272\u304c\u6b7b\u4ea1\u306b\u81f3\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u8133\u810a\u9ac4\u7167\u5c04\u3042\u308b\u3044\u306f\u3001\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u5c40\u6240\u7167\u5c04\u3092\u53d7\u3051\u305f\u6642\u306b\u751f\u5b58\u3057\u5f97\u305f\u3088\u3046\u3067\u3059\u30024\u6b73\u4ee5\u4e0a\u3067\u64ad\u7a2e\u304c\u306a\u3044\u5834\u5408\u306e5\u5e74\u751f\u5b58\u5272\u5408\u306f70%\u7a0b\u5ea6\u3001\u64ad\u7a2e\u304c\u3042\u3063\u305f\u5834\u5408\u306750%\u307b\u3069\u3067\u3057\u305f\u3002\u3053\u306e\u5e74\u9f62\u5c64\u3067\u306f\u307b\u3068\u3093\u3069\u304c\u8133\u810a\u9ac4\u7167\u5c04\u3068\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u3002\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u9806\u5e8f\u306b\u30a4\u30f3\u30d1\u30af\u30c8\u306f\u306a\u304f\u3001\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u30a4\u30f3\u30d1\u30af\u30c8\u3082\u4f4e\u304b\u3063\u305f\u3068\u306e\u7d50\u8ad6\u3067\u3059\u30024\u6b73\u4ee5\u4e0b\u3067\u306f\u3001\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u5c40\u6240\u7167\u5c04\u304c\u63d0\u6848\u3055\u308c\u308b\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">PPTID\u306fsmall-cell type\u3068large-cell type\u306b\u5206\u985e\u3055\u308c\u308b<\/h4>\n\n\n\n<p><span class=\"docsum-authors full-authors\">Raleigh DR:&nbsp;<\/span>Histopathologic review of pineal parenchymal tumors identifies novel morphologic subtypes and prognostic factors for outcome. Neuro Oncol 2017<br>UCSF\u304b\u3089\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d70\u4f8b\u306e\u7dcf\u62ec\u5831\u544a\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\u3001PPTID\u306f\u3001\u7d44\u7e54\u5b66\u7684\u306b2\u3064\u306e\u30bf\u30a4\u30d7\u306b\u5206\u985e\u3055\u308c\u308b\u3068\u306e\u3053\u3068\u3067\u3059\u3002small-cell morphologic subtype\u3068 large-cell morphologic subtype\u3067\u3059\u3002\u5927\u304d\u306a\u7d30\u80de\u3067\u69cb\u7bc9\u3055\u308c\u308bPPTID\u306e\u4e88\u5f8c\u306f\u60aa\u3044\u3088\u3046\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">St. Jude\u5b50\u4f9b\u75c5\u9662\u3067\u306e\u677e\u679c\u4f53\u82bd\u816b\uff1a\u5e74\u9577\u5150\u3067\u306f\u521d\u767a\u6642\u306b\u5168\u6458\u51fa\u3057\u305f\u65b9\u304c\u826f\u3044<\/h4>\n\n\n\n<p class=\"heading-title\"><span class=\"authors-list-item \">Parikh K:&nbsp;<\/span>Pineoblastoma-The Experience at St. Jude Children&#8217;s Research Hospital. Neurosurgery 2017<br>1997\u5e74\u304b\u30892015\u5e74\u307e\u3067\u306b41\u4f8b\u306e\u677e\u679c\u4f53\u82bd\u816b\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u5e74\u9f62\u4e2d\u592e\u5024\u306f5.5\u6b73\u3067\u3001\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u502434\u30f6\u6708\u3067\u3059\u300219\u4f8b\u304c\u4e2d\u592e\u502411\u30f6\u6708\u3067\u518d\u767a\u3057\u3066\u300118\u4f8b\u304c\u4ea1\u304f\u306a\u308a\u307e\u3057\u305f\u3002\u518d\u767a\u4f8b\u306e\u5e74\u9f62\u4e2d\u592e\u5024\u306f2.7\u6b73\u3067\u5e7c\u3044\u4f8b\u306b\u591a\u304f\u3001\u8a3a\u65ad\u6642\u306b\u64ad\u7a2e\u8ee2\u79fb\u304c\u3059\u3067\u306b\u3042\u3063\u305f\u4f8b\u3067\u3042\u3063\u305f\u305d\u3046\u3067\u3059\u30025\u6b73\u4ee5\u4e0a\u3067\u64ad\u7a2e\u304c\u306a\u3044\u4f8b\u3067\u306f\u3001\u521d\u767a\u6642\u306b\u5168\u6458\u51fa\u3082\u3057\u304f\u306fnear-total resection\u304c\u3067\u304d\u3066\u3044\u305f\u5834\u5408\u306b\u3001\u518d\u767a\u6b7b\u4ea1\u4f8b\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u521d\u56de\u6cbb\u7642\u3067\u5168\u6458\u51fa\u3057\u305f\u65b9\u304c\u826f\u3044 maximal tumor resection should be the goal \u3068\u306e\u7d50\u8ad6\u3067\u3057\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u677e\u679c\u4f53\u816b\u760d\u3078\u306e\u30ac\u30f3\u30de\u30ca\u30a4\u30d5 \u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642 SRS\u306e\u6cbb\u7642\u6210\u7e3e<\/h4>\n\n\n\n<p><span class=\"docsum-authors full-authors\">Iorio-Morin C:&nbsp;<\/span>Histology-Stratified Tumor Control and Patient Survival After Stereotactic Radiosurgery for Pineal Region Tumors: A Report From the International Gamma Knife Research Foundation. World Neurosurg. 2017<br>1989\u5e74\u304b\u30892014\u5e74\u306b70\u4f8b\u304cSRS\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002pineocytoma (26\u4f8b), pineoblastoma (13\u4f8b), pineal parenchymal tumor of intermediate differentiation (7\u4f8b), papillary tumor of the pineal region (6\u4f8b)\u3092\u542b\u307f\u307e\u3059\u3002\u677e\u679c\u4f53\u7d30\u80de\u816b\u306720\u5e74\u5236\u5fa1\u5272\u5408 control rate\u306f81\uff05\u3001PPTID\u30675\u5e74\u5236\u5fa1\u5272\u5408\u306f50%\u3001\u677e\u679c\u4f53\u82bd\u816b\u306727%\u3067\u3057\u305f\u3002\u3053\u306e\u6cbb\u7642\u6210\u7e3e\u306f\u304b\u306a\u308a\u60aa\u3044\u3068\u8a00\u308f\u3056\u308b\u3092\u5f97\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u677e\u679c\u4f53\u82bd\u816b\u306e5\u5e74\u751f\u5b58\u5272\u5408\u306f70%\u307b\u3069?<\/h4>\n\n\n\n<p><span class=\"authors-list-item \">Farnia B:&nbsp;<\/span>Clinical outcomes and patterns of failure in pineoblastoma: a 30-year, single-institution retrospective review. World Neurosurg 2014<br>MD\u30a2\u30f3\u30c0\u30fc\u30bd\u30f3\u75c5\u9662\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30021982\u5e74\u304b\u30892012\u5e74\u307e\u3067\u306b31\u4f8b\u306e\u677e\u679c\u4f53\u82bd\u816b\u304c\u6cbb\u7642\u3055\u308c\u3066\u3044\u3066\u3001\u5e74\u9f62\u4e2d\u592e\u5024\u306f18\u6b73\u3067\u3057\u305f\u300221\u4f8b\u3067\u5916\u79d1\u6458\u51fa\u304c\u884c\u308f\u308c\u3001\u5168\u6458\u51fa\u306f9\u4f8b\u3067\u3057\u305f\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306f30\u4f8b\u3067\u3001\u5206\u5272\u7167\u5c0416\u4f8b\u3001\u967d\u5b50\u7dda\u7167\u5c0413\u4f8b\u3001\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u76421\u4f8b\u3067\u3057\u305f\u3002\u8133\u810a\u9ac4\u306f36\u30b0\u30ec\u30a4\u3001\u816b\u760d\u5c40\u6240\u306f54\u30b0\u30ec\u30a4\u304c\u7528\u3044\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u306e\u6642\u671f\u306f\u69d8\u3005\u3067\u3042\u308a\u3001\u7167\u5c04\u524d10\u4f8b\u3001\u7167\u5c04\u4e2d10\u4f8b\u3001\u7167\u5c04\u5f8c22\u4f8b\u3067\u3059\u3002\u5168\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f8.7\u5e74\u3067\u30015\u5e74\u751f\u5b58\u5272\u5408\u306f70%\u307b\u3069\u3067\u3059\u3002\u64ad\u7a2e\u3092\u4f34\u3046\u4f8b\u3067\u6cbb\u7642\u304c\u96e3\u3057\u304f\u3001\u8133\u810a\u9ac4\u7167\u5c04\u306f\u5fc5\u8981\u3067\u3042\u308b\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u3053\u306e\u5831\u544a\u306e\u5e74\u9f62\u4e2d\u592e\u5024\u306f\u3068\u3066\u3082\u9ad8\u3044\u3067\u3059\u3002\u3082\u3057\u304b\u3059\u308b\u3068PPTID\u304c\u6df7\u5728\u3057\u3066\u3044\u308b\u306e\u3067\u9577\u671f\u751f\u5b58\u7387\u304c\u9ad8\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong><span class=\"style1\">\u5c0f\u5150\u306e\u677e\u679c\u4f53\u82bd\u816b\u3078\u306e\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5<\/span><\/strong><\/span><\/h4>\n\n\n\n<p>Hinkes BG et al. Childhood pineoblastoma: experience from the prospective multicenter trials HIT-SKK87, HIT-SKK92 and HIT91. J Neurooncol 2007<br>\u30c9\u30a4\u30c4\u3092\u4e2d\u5fc3\u306b\u3057\u3066\u3055\u308c\u305f\u81e8\u5e8a\u7814\u7a76\u306711\u4eba\u306e\u5b50\u4f9b\u305f\u3061\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\uff13\u6b73\u672a\u6e80\u306f\uff15\u4eba\u3067\uff0c\uff13\u6b73\u4ee5\u4e0a\u306f\uff16\u4eba\u3067\u3059\u3002\uff13\u6b73\u4ee5\u4e0a\u306e\uff16\u4eba\u3067\u306f\uff0c\u624b\u8853\u306e\u5f8c\u306b\u5168\u8133\u810a\u9ac4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\u304c\u3055\u308c\u3066\uff0c\uff15\u4eba\u3067\u816b\u760d\u304c\u6d88\u5931\u3057\u3066\uff0c\u4e2d\u592e\u5024\uff18\u5e74\u306e\u6bb5\u968e\u3067\uff15\u4eba\u304c\u751f\u5b58\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\uff13\u6b73\u672a\u6e80\u306e\uff15\u4eba\u3067\u306f\u4e2d\u592e\u5024\uff11\u5e74\u304f\u3089\u3044\u3067\u5168\u54e1\u304c\u6b7b\u4ea1\u3057\u3066\u3044\u307e\u3059\u3002\uff13\u6b73\u672a\u6e80\u3067\u306f\uff0c\u64ad\u7a2e\u304c\u3042\u3063\u305f\u3053\u3068\uff0c\u624b\u8853\u3067\u5168\u90e8\u53d6\u308c\u306a\u304b\u3063\u305f\u3053\u3068\uff0c\u5e7c\u3044\u306e\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u306a\u304b\u3063\u305f\u3053\u3068\u304c\u6b7b\u4ea1\u306e\u539f\u56e0\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u307e\u305f\uff13\u6b73\u672a\u6e80\u306e\u5c0f\u3055\u306a\u5b50\u4f9b\u306b\u3067\u304d\u308b\u677e\u679c\u4f53\u82bd\u816b\u306f\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u306e\u3067\u306f\u306a\u3044\u304b\u3068\u60f3\u50cf\u3055\u308c\u3066\u3044\u307e\u3059\u3002<br>\u89e3\u8aac\uff1a\u677e\u679c\u4f53\u82bd\u816b\u306f\uff0c\u8133\u306b\u6d78\u6f64\u3057\u3066\u7652\u7740\u3059\u308b\u306e\u3067\u624b\u8853\u3067\u5168\u90e8\u53d6\u308c\u306a\u3044\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u3067\u3059\u304b\u3089\u624b\u8853\u3067\u8a3a\u65ad\u304c\u3064\u3044\u305f\u3089\u3059\u3050\u306b\uff0c\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u3092\u542b\u3081\u305f\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\u3092\u958b\u59cb\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3067\u3057\u3087\u3046\u3002\u4e00\u65b9\uff0c\u5c0f\u3055\u306a\u5b50\u4f9b\u306b\u306f\u5168\u8133\u810a\u9ac4\u7167\u5c04\u304c\u3067\u304d\u306a\u3044\u306e\u3067\uff0c\u5185\u8996\u93e1\u3067\u306e\u751f\u691c\u8853\u3067\u75c5\u7406\u8a3a\u65ad\u304c\u3064\u3044\u305f\u3089\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u3059\u3050\u306b\u958b\u59cb\u3057\u3066\uff0c\u64ad\u7a2e\u304c\u306a\u3044\u6642\u306b\u306f\u677e\u679c\u4f53\u816b\u760d\u306b\u5bfe\u3059\u308b\u5c40\u6240\u7167\u5c04\u3082\u540c\u6642\u306b\u4f75\u7528\u3059\u308b\u3079\u304d\u3067\u3057\u3087\u3046\u3002\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3067\u306f\u6cbb\u3089\u306a\u3044\u3067\u3057\u3087\u3046\u3057\uff0c\u5b50\u4f9b\u3067\u3042\u3063\u3066\u3082\u677e\u679c\u4f53\u5c40\u6240\u306e\u307f\u3067\u3042\u308c\u3070\u653e\u5c04\u7dda\u306b\u3088\u308b\u8a8d\u77e5\u969c\u5bb3\u3082\u53d7\u3051\u5165\u308c\u3089\u308c\u308b\u7a0b\u5ea6\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Trilateral retinoblastoma\u306b\u5408\u4f75\u3057\u305f\u677e\u679c\u4f53\u82bd\u816b\u306e\u5316\u5b66\u7642\u6cd5<\/h4>\n\n\n\n<p><span style=\"color: #000000;\">Dunkel IJ, et al.: Trilateral retinoblastoma: potentially curable with intensive chemotherapy. Pediatr Blood Cancer 54: 384-387, 2010<br><\/span><span style=\"color: #000000;\">\u3053\u306e\u8ad6\u6587\u306b\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u3067\u3042\u3063\u305f\u4f8b\u304c\u8a18\u8f09\u3055\u308c\u3066\u3044\u307e\u3059\u3002Induction chemotherapy generally included vincristine, cisplatin or carboplatin, cyclophosphamide, and etoposide. Hematopoietic stem cells typically were harvested after the first or second cycle of induction chemotherapy, usually from peripheral blood. High-dose chemotherapy regimens were thiotepa-based (n = 7) or melphalan and cyclophosphamide (n = 3).<br><\/span><span style=\"color: #000000;\">\u3053\u306e\u6cbb\u7642\u306713\u4eba\u306e\u3046\u3061\u306e5\u4eba\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u308b\u3053\u3068\u306a\u304f\u7121\u5897\u60aa\u9577\u671f\u751f\u5b58\u3057\u3066\u3044\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3067\u3082\u751f\u5b58\u8005\u306e5\u4eba\u306e\u3046\u30614\u4eba\u306f\u64ad\u7a2e\u304c\u306a\u3044\u60a3\u5150\u3067\u3057\u305f\u3002&nbsp;<\/span><\/p>\n\n\n\n<h4 class=\"wp-block-heading style1\"><span style=\"color: #000080;\">\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306e\u4e88\u5f8c\u56e0\u5b50<\/span><\/h4>\n\n\n\n<p>Fauchon F, et al.: Pineal parenchymal tumors: clinicopathological study of 76 cases. Int J Radiat Oncol Biol Phys. 46:959-968, 2000<br>19\u4f8b\u306e\u677e\u679c\u4f53\u7d30\u80de\u816b\uff0c28\u4f8b\u306e\u4e2d\u9593\u578b PPTID\uff0c29\u4f8b\u306e\u677e\u679c\u4f53\u82bd\u816b\u306e\u8ffd\u8de1\u5831\u544a\u3067\u3059\u3002 \u8457\u8005\u3089\u306e\u5206\u985e\u3067\u306f\uff0cgrade I\u306f11\u4f8b\uff0cgrade II\u306f27\u4f8b\uff0cgrade III\u306f20\u4f8b\uff0cgrade IV\u306f18\u4f8b\u3060\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u7a4d\u6975\u7684\u306a\u5916\u79d1\u5207\u9664\u306f44\u4f8b\u3067\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u5468\u8853\u671f\u306b\uff19\u4f8b\u304c\u6b7b\u4ea1\u3057\u3066\u3044\u307e\u3059\u300244\u4eba\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\uff0c15\u4eba\u304c\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u3002\u89b3\u5bdf\u671f\u9593\u4e2d\u592e\u502485\u30f6\u6708\u306741\u4eba(54%)\u304c\u751f\u5b58\u3057\u3066\u3044\u307e\u3059\u3002\u6cbb\u7642\u5f8c\u306e\u518d\u71c3\u306f26\u4eba\u306b\u307f\u3089\u308c\u307e\u3057\u305f\u3002\u4e88\u5f8c\u306e\u826f\u304b\u3063\u305f\u56e0\u5b50\u3068\u3057\u3066\uff0c\u5e74\u9f62\u304c20\u6b73\u4ee5\u4e0a\uff0c\u816b\u760d\u306e\u5f84\u304c25mm\u672a\u6e80\uff0c\u7d44\u7e54\u5b66\u7684\u306b\u60aa\u6027\u5ea6\u304c\u4f4e\u3044(low grade)\u3067\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading style1\"><span style=\"color: #000080;\">\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306e\u4e88\u5f8c\u56e0\u5b50<\/span><\/h4>\n\n\n\n<p>Jouvet A, et al.: Pineal parenchymal tumors: a correlation of histological features with prognosis in 66 cases. Brain Pathol 10: 49-60, 2000<br>66\u4f8b\u306e\u677e\u679c\u4f53\u5b9f\u8cea\u816b\u760d\u306e\u8abf\u67fb\u3067\u3059\u3002\u677e\u679c\u4f53\u7d30\u80de\u816b\u304c11\u4f8b\uff0c\u4e2d\u9593\u578b\u304c39\u4f8b\uff0c\u677e\u679c\u4f53\u82bd\u816b\u304c16\u4f8b\u3067\u3059\u3002\u4e88\u5f8c\u304c\u60aa\u3044\u56e0\u5b50\u3068\u3057\u3066\uff0c\u6838\u5206\u88c2\u50cf\u304c\u591a\u3044 (mitotic index &gt; 6 per HPFs, MIB-1\u3068\u306f\u9055\u3046\u306e\u3067\u6ce8\u610f\uff01)\uff0c \u58ca\u6b7b\u306e\u5b58\u5728\uff0cneurofilamane protein\u9670\u6027\u306a\u3069\u3092\u3042\u3052\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"#top2\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/navi\/pagetop.gif\" alt=\"\u3053\u306e\u30da\u30fc\u30b8\u306e\u30c8\u30c3\u30d7\u306b\u623b\u308b\"\/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-225x300.jpg\" alt=\"solaillust2\" class=\"wp-image-9318\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-225x300.jpg 225w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-768x1024.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-450x600.jpg 450w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2.jpg 1108w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u677e\u679c\u4f53\u5468\u56f2\u306e\u9759\u8108\u6d1e<\/h4>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pinealanat1.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pinealanat1.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pinealanat2.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pineal\/pinealanat2.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<p class=\"imgCenter\"><br><\/p>\n\n\n\n<p>Overview of the pineal region through the right occipital area. The occipital lobes, the falx, the tentorium, and the arachnoid membranes have been removed. BV = basal vein of Rosenthal, CV = cerebellar vermis, G = great vein of Galen, ICV = internal cerebral vein, MOV = medial occipital vein, P = pulvinar, PV = pericallosal vein, Q = quadrigeminal plate, S = splenium, SS = straight sinus, TS = transverse sinus<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u6587\u732e<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Allen JC, Kim JH, Packer RJ: Neoadjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system. J Neurosurg 67: 65-70, 1987<\/li>\n\n\n\n<li>Allen JC, DaRosso RC, Donahue B, Nirenberg A: A phase II trial of preirradiation carboplatin in newly diagnosed germinoma of the central nervous system. Cancer : 940-944, 1994<\/li>\n\n\n\n<li>Aoyama H, Shirato H, Ikeda J, Fujieda K, Miyasaka K, Sawamura Y: Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors. J Clin Oncol 20: 857-865, 2002<\/li>\n\n\n\n<li>Balmaceda C, Heller G, Rosenblum M, Diez B, Villablanca JG, Kellie S, Maher P, Vlamis V, Walker RW, Leibel S, Finlay JL (1996) Chemotherapy without irradiation &#8211; A novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial.\u3000 J Clin Oncol 14: 2908-2915.<\/li>\n\n\n\n<li>Bamberg M, Kortmann RD, Calaminus G, Becker G, Meisner C, Harms D, Gobel U: Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83\/86\/89. J Clin Oncol 17:2585-2592, 1999<\/li>\n\n\n\n<li>Bayens YC, Helle PA, Van Putten WL, Mali SP (1992) Orchidectomy followed by radiotherapy in 176 stage I and II testicular seminoma patients: benefits of a 10-year follow-up study. Radiother Oncol 25: 97-102.<\/li>\n\n\n\n<li>Calaminus G, Bamberg M, Baranzelli MC, Benoit Y, di Montezemolo LC, Fossati-Bellani F, Jurgens H, Kuhl HJ, Lenard HG, Curto ML : Intracranial germ cell tumors: a comprehensive update of the European data. Neuropediatrics 25: 26-32, 1994<\/li>\n\n\n\n<li>Chang SM, Lillis-Hearne PK, Larson DA, Wara WM, Bollen AW, Prados MD: Pineoblastoma in adults. Neurosurgery 37: 383-390, 1995<\/li>\n\n\n\n<li>Chiechi MV, Smirniotopoulos JG, Mena H (1995) Pineal parenchymal tumors: CT and MR features. J Comput Assist Tomogr 19: 509-171<\/li>\n\n\n\n<li>D&#8217;Andrea AD, Packer RJ, Rorke LB, Bilaniuk LT, Sutton LN, Bruce DA, Schut L (1987) Pineocytomas of childhood. A reappraisal of natural history and response to therapy. Cancer 59: 1353-1357<\/li>\n\n\n\n<li>Fauchon F, Jouvet A, Paquis P, Saint-Pierre G, Mottolese C, Ben Hassel M, Chauveinc L, Sichez JP, Philippon J, Schlienger M, Bouffet E: Parenchymal pineal tumors: a clinicopathological study of 76 cases. Int J Radiat Oncol Biol Phys. 2000 Mar 1;46(4):959-68<\/li>\n\n\n\n<li>Jakacki RI, Zeltzer PM, Boyett JM, Albright AL, Allen JC, Geyer JR, Rorke LB, Stanley P, Stevens KR, Wisoff J, et al.: Survival and prognostic factors following radiation and\/or chemotherapy for primitive neuroectodermal tumors of the pineal region in infants and children: a report of the Childrens Cancer Group. J Clin Oncol 13: 1377-1383, 1995<\/li>\n\n\n\n<li>Jouvet A, Saint-Pierre G, Fauchon F, Privat K, Bouffet E, Ruchoux MM, Chauveinc L, Fevre-Montange M: Pineal parenchymal tumors: a correlation of histological features with prognosis in 66 cases. Brain Pathol. 2000 Jan;10(1):49-60<\/li>\n\n\n\n<li>Kochi M, Itoyama Y, Shiraishi S, Kitamura I, Marubayashi T, Ushio Y: Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors. J Neurosurg 99: 106-114, 2003<\/li>\n\n\n\n<li>Lutterbach J, Fauchon F, Schild SE, Chang SM, nstecher A, Volk B, Ostertag C, Momm F, Jouvet A: Malignant pineal parenchymal tumors in adult patients: patterns of care and prognostic factors. Neurosurgery 51: 44-55, 2002<\/li>\n\n\n\n<li>Sawamura Y, de Tribolet N, Ishii N, Abe H (1997) Surgical management of primary intracranial germinomas: diagnostic surgery or radical Resection ? J Neurosurg 87: 262-266<\/li>\n\n\n\n<li>Sawamura Y, Ikeda J, Shirato H, Tada M, Abe H (1998) Germ cell tumors of the central nervous system: treatment consideration based on 111 cases and their long-term clinical outcomes. Eur J Cancer 34: 104-110<\/li>\n\n\n\n<li>Sawamura Y, de Tribolet N: Neurosurgical management of pineal tumors. Adv Tech Stand Neurosurg 27: 1-22, 2001<\/li>\n\n\n\n<li>Schild SE, Scheithauer BW, Schomberg PJ, Hook CC, Kelly PJ, Frick L, Robinow JS, Buskirk SJ: Pineal parenchymal tumors. Clinical, pathologic, and therapeutic aspects. Cancer 72: 870-880, 1993<\/li>\n\n\n\n<li>The Committee of Brain Tumor Registry of Japan (BTRJ): Brain Tumor Registry of Japan (BTRJ 1969-1996), 11th edition, Neurol-Med Chir 43: 29, 2003 (suppl)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\u5c71\u672c\u54f2\u54c9\u3082\u8a18\u8f09\u3057\u3066\u3044\u307e\u3059 \u677e\u679c\u4f53\u816b\u760d\u306b\u95a2\u3057\u3066\uff0c\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u306e\u5c71\u672c\u54f2\u54c9\u5148\u751f\u304c\u5fa1\u76f8\u8ac7\u306b\u306e\u308a\u307e\u3059\uff0c\u76f8\u8ac7\u3057\u305f\u3044\u65b9\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u304f\u3060\u3055\u3044 \u5c71\u672c \u54f2\u54c9\uff08\u3084\u307e\u3082\u3068 \u3066\u3064\u3084\uff09\u3000\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u9644\u5c5e\u75c5\u9662 \u8133\u795e\u7d4c\u5916\u79d1 \u8a3a\u7642\u79d1\u90e8\u9577\u3000\u6a2a\u6d5c\u5e02\u7acb [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-140","post","type-post","status-publish","format-standard","hentry","category-braintumors"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/140","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/comments?post=140"}],"version-history":[{"count":169,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/140\/revisions"}],"predecessor-version":[{"id":23979,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/140\/revisions\/23979"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=140"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=140"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=140"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}