{"id":8572,"date":"2016-03-28T15:00:29","date_gmt":"2016-03-28T06:00:29","guid":{"rendered":"\/sawamura\/?p=8572"},"modified":"2020-04-04T10:59:07","modified_gmt":"2020-04-04T01:59:07","slug":"mixedgermcelltumor","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/mixedgermcelltumor\/","title":{"rendered":"\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d mixed germ cell tumor"},"content":{"rendered":"<h1><span style=\"color: #ff0000;\">\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3068\u3044\u3046\u75c5\u7406\u8a3a\u65ad\u540d\u306f\u6cbb\u7642\u6cd5\u9078\u629e\u306b\u4f7f\u308f\u306a\u3044<\/span><\/h1>\n<p>\u7406\u7531\uff1a\u6210\u719f\u5947\u5f62\u816b\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6df7\u5408\u578b\u306f\u307b\u3068\u3093\u3069\u6cbb\u7642\u5408\u4f75\u75c7\u3092\u751f\u3058\u308b\u3053\u3068\u306a\u304f\u6cbb\u7652\u3057\u307e\u3059\u3002\u4e00\u65b9\u3067\uff0c\u80ce\u5150\u6027\u304c\u3093\u3068\u5375\u9ec4\u56a2\u816b\u3068\u672a\u719f\u5947\u5f62\u816b\u304c\u307e\u3058\u3063\u305f\u6df7\u5408\u578b\u306f\u307b\u3068\u3093\u3069\u52a9\u304b\u308a\u307e\u305b\u3093\u3002\u4e21\u65b9\u3068\u3082\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d mixed germ cell tumor \u3068\u3044\u3046\u75c5\u7406\u8a3a\u65ad\u540d\u3067\u3059\u304c\uff0c\u540c\u3058\u6cbb\u7642\u306f\u3067\u304d\u306a\u3044\u304b\u3089\u3067\u3059\u3002<\/p>\n<hr \/>\n<ul>\n<li>\u3069\u306e\u3088\u3046\u306a\u816b\u760d\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u304b\uff0c\u75c5\u7406\u8a3a\u65ad\u304c\u6700\u3082\u5927\u5207\u3067\u3059<\/li>\n<li>\u816b\u760d\u3092\u5168\u6458\u51fa\u3059\u308c\u3070\u75c5\u7406\u8a3a\u65ad\u306f\u78ba\u5b9f\u306a\u306e\u3067\u3059\u304c\uff0c\u73fe\u5b9f\u7684\u306b\u306f\u751f\u691c\u8853\u304c\u307b\u3068\u3093\u3069\u3067\u3059<\/li>\n<li>\u751f\u691c\u8853\u3067\u3059\u3068\u816b\u760d\u306e\u3054\u304f\u5fae\u5c0f\u306a\u7d44\u7e54\u3057\u304b\u53d6\u308c\u306a\u3044\u306e\u3067\uff0c<span style=\"color: #ff0000;\"><strong>\u75c5\u7406\u8a3a\u65ad\u3092\u3057\u3070\u3057\u3070\u8aa4\u308a\u307e\u3059<\/strong><\/span><\/li>\n<li>\u6df7\u3058\u3063\u3066\u3044\u308b\u3082\u306e\u306e\u4e2d\u3067\u6700\u3082\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u75c5\u7406\u6240\u898b\u306b\u3042\u308f\u305b\u3066\u6cbb\u7642\u8a08\u753b\u3092\u7acb\u3066\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u672a\u719f\u5947\u5f62\u816b\u306e\u6df7\u5408\u578b\u304c\u3082\u3063\u3068\u3082\u591a\u3044<\/strong><\/span>\u3067\u3059<\/li>\n<\/ul>\n<hr \/>\n<h4><span style=\"color: #000080;\"><strong>\u6210\u719f\u5947\u5f62\u816b\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6df7\u5408\u578b teratoma and germinoma<\/strong><\/span><\/h4>\n<ul>\n<li><span style=\"color: #000000;\">CT\u3068MRI\u753b\u50cf\u3092\u307f\u308b\u3068\u5947\u5f62\u816b\u304c\u307e\u305a\u7591\u308f\u308c\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #000000;\">\u816b\u760d\u30de\u30fc\u30ab\u30fc\u306f\uff0c<\/span><span style=\"color: #000000;\">HCG-beta\u304bAFP\u304c\u3054\u304f\u8efd\u5ea6\u306b\u4e0a\u6607\u3057\u3066\u3044\u308b\u304b\u611f\u77e5\u3067\u304d\u306a\u3044\u30ec\u30d9\u30eb\u3067\u3059<\/span><\/li>\n<li>\u75c5\u7406\u8a3a\u65ad\u304c\u3067\u304d\u3066\u3044\u306a\u3044\u3068\u6cbb\u7642\u65b9\u91dd\u304c\u6c7a\u307e\u308a\u307e\u305b\u3093\u304b\u3089\uff0c\u751f\u691c\u624b\u8853\u3082\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>\u751f\u691c\u8853\u3092\u3057\u307e\u3059\u3068\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u90e8\u5206\u306f\u63a1\u53d6\u3057\u3084\u3059\u3044\u306e\u3067\u3059\u304c\uff0c\u6210\u719f\u5947\u5f62\u816b\u306e\u90e8\u5206\u306f\u63a1\u53d6\u3057\u3065\u3089\u3044\u306e\u3067\uff0c\u201d\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u201d\u3068\u3044\u3046\u75c5\u7406\u78ba\u5b9a\u8a3a\u65ad\u304c\u3064\u3044\u3066\u3057\u307e\u3044\u307e\u3059<\/li>\n<li>\u3053\u306e\u6642\u70b9\u3067\uff0cMRI\u753b\u50cf\u8a3a\u65ad\u3068\u75c5\u7406\u8a3a\u65ad\u306e\u77db\u76fe\u304c\u751f\u3058\u307e\u3059<\/li>\n<li><span style=\"color: #000000;\">\u6210\u719f\u5947\u5f62\u816b\u306b\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u52b9\u304d\u307e\u305b\u3093<\/span><\/li>\n<li><span style=\"color: #000000;\">\u6210\u719f\u5947\u5f62\u816b\u306f\uff0c\u958b\u982d\u624b\u8853\u3067\u5b8c\u5168\u6458\u51fa\u3067\u304d\u306a\u3044\u3068\u5b8c\u6cbb\u306f\u3057\u307e\u305b\u3093<\/span><\/li>\n<li><span style=\"color: #000000;\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3068\u4f4e\u7dda\u91cf\u306e\u5168\u8133\u5ba4\u7167\u5c04\u3067\u6cbb\u3057\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #000000;\">\u3053\u308c\u3089\u3092\u8003\u3048\u5408\u308f\u305b\u308b\u3068\uff0c\u753b\u50cf\u8a3a\u65ad\u3057\u3066\uff0c\u751f\u691c\u624b\u8853\u3092\u3057\u3066\uff0c\u3055\u3089\u306b\u958b\u982d\u624b\u8853\u3068\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\uff0824\u221225.2\u30b0\u30ec\u30a4\uff0c\u5168\u8133\u5ba4\u7167\u5c04\uff09\u3067\u3059<\/span><\/li>\n<li>\u4fb5\u8972\u7684\u306a\u6cbb\u7642\u3092\u3057\u306a\u304f\u3066\u306f\u306a\u3089\u306a\u3044\u304b\u3069\u3046\u304b\u3092\u3088\u304f\u3088\u304f\u8003\u3048\u307e\u3059<\/li>\n<li>\u7c73\u56fd\u3067\u306f\u3053\u306e\u30bf\u30a4\u30d7\u3092non-germinomatous germ cell tumor\u3068\u3057\u3066\uff0c\u5375\u9ec4\u56a2\u816b\u3068\u540c\u3058\u6cbb\u7642\u304c\u3055\u308c\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\uff0c\u305d\u308c\u3069\u3046\u8003\u3048\u3066\u3082\u304a\u304b\u3057\u3044\u3067\u3059\uff0cover treatment\u3067\u3059<\/li>\n<\/ul>\n<hr \/>\n<h4><span style=\"color: #000080;\"><strong>\u672a\u719f\u5947\u5f62\u816b\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6df7\u5408\u578b immature teratoma and germinoma<\/strong><\/span><\/h4>\n<ul>\n<li>\u6210\u719f\u5947\u5f62\u816b\u306b\u6bd4\u3079\u3066\u3084\u3063\u304b\u3044\u306a\u3082\u306e\u3067\u3059<\/li>\n<li>\u672a\u719f\u5947\u5f62\u816b\u306b\u306f\u60aa\u6027\u5ea6\u306e\u4f4e\u3044\u3082\u306e\u304b\u3089\uff0c\u64ad\u7a2e\u6027\u683c\u3092\u3082\u3064\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u3082\u306e\u307e\u3067\u3042\u308a\u307e\u3059<\/li>\n<li>ICE\u5316\u5b66\u7642\u6cd5\uff0c\u5168\u8133\u5ba4\u7167\u5c04\uff0c\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u6458\u51fa\u3067\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u7dda\u91cf\u306f45\u30b0\u30ec\u30a4\u304b\u308954\u30b0\u30ec\u30a4\u7a0b\u5ea6\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>\u816b\u760d\u6458\u51fa\u3067\u624b\u8853\u8a98\u767a\u64ad\u7a2e\u3092\u62db\u304f\u3068\u6cbb\u7642\u306e\u65b9\u6cd5\u304c\u306a\u304f\u306a\u308a\u307e\u3059<\/li>\n<\/ul>\n<h5><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/yolksactumor\/\"><span style=\"color: #000080;\">AFP\u304c\u975e\u5e38\u306b\u9ad8\u3044\u5947\u5f62\u816b\u3092\u542b\u3080\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u306f<br \/>\n<\/span>\u5375\u9ec4\u56a2\u306e\u3046\u816b yolk sac tumor \u306e\u3068\u3053\u308d\u3092\u8aad\u3093\u3067\u304f\u3060\u3055\u3044<\/a><\/h5>\n<h5><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/germcelltumors\/epidermoidgerminoma\/\">\u985e\u76ae\u306e\u3046\u80de\u306e\u4e00\u90e8\u306b\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u6df7\u3058\u308b\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d<\/a><\/span><br \/>\n<span style=\"color: #000080;\">\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000<a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/epidermoidgerminoma\/\">\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/span><\/h5>\n<hr \/>\n<h4>\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u5927\u8133\u57fa\u5e95\u6838\u6210\u719f\u5947\u5f62\u816b<br \/>\nneurophypophyseal germinoma with basal ganglia mature teratoma<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15244\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy1-294x300.jpg\" alt=\"\" width=\"294\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy1-294x300.jpg 294w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy1-550x562.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy1-768x784.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy1.jpg 850w\" sizes=\"auto, (max-width: 294px) 100vw, 294px\" \/><br \/>\n12\u6b73\u306e\u7537\u5150\u304c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u304c\uff0c7\u30f6\u6708\u9593\u8a3a\u65ad\u304c\u3064\u304b\u305a\u306b\u4f4e\u30ca\u30c8\u30ea\u30a6\u30e0\u8840\u75c7\u306b\u3088\u308b\u5168\u8eab\u75d9\u6523\u3092\u751f\u3058\u307e\u3057\u305f\u3002\u4e0b\u5782\u4f53\u3068\u53f3\u88ab\u6bbb\u306e\uff12\u7b87\u6240\u306b\u816b\u760d\u304c\u3042\u308a\uff0cAFP 33ng\/ml, HCG-beta 1.0mIU\u3068\u4e0a\u6607\u304c\u307f\u3089\u308c\u307e\u3057\u305f\u3002\u795e\u7d4c\u4e0b\u5782\u4f53\u306e\u751f\u691c\u8853\u3067germinoma\u306e\u8a3a\u65ad\u3067\u3042\u3063\u305f\u305f\u3081\u306b\u5316\u5b66\u7642\u6cd5\u304c\u958b\u59cb\u3055\u308c\u307e\u3057\u305f\u3002CPA, VP-16, CDDP, VCR\u306e\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u306b\uff0cMTX\u306e\u9ac4\u8154\u5185\u6ce8\u5165\u304c2\u56de\u3067\u3057\u305f\u3002\u306a\u305c\u3053\u306e\u3088\u3046\u306a\u4e71\u66b4\u306a\u5316\u5b66\u7642\u6cd5\u3092\u884c\u306a\u3063\u305f\u306e\u304b\u306f\u4e0d\u660e\u3067\u3059\u3002\u5f53\u7136\u3067\u3059\u304c\uff0c\u4e0b\u5782\u4f53\u306egerminoma\u306f\u5de6\u5074\u306e\u3088\u3046\u306b\u6d88\u5931\u3057\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15247\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy2-291x300.jpg\" alt=\"\" width=\"291\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy2-291x300.jpg 291w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy2-550x567.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy2-768x792.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy2.jpg 850w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><br \/>\n\u3067\u3082\u5316\u5b66\u7642\u6cd5\u4e2d\u306b\uff0c\u53f3\u5927\u8133\u57fa\u5e95\u6838\u306b\u3042\u3063\u305f\u816b\u760d\u304c\u5897\u5927\u3057\u3066\uff0c\u5de6\u306eMRI\u306e\u3088\u3046\u306b\u8133\u6d6e\u816b\u3082\u60aa\u5316\u3057\u307e\u3057\u305f\u3002\u3053\u306e\u6642\u70b9\u3067\u60a3\u8005\u3055\u3093\u304c\u8ee2\u9662\u3057\u3066\u304d\u307e\u3057\u305f\u3002\u816b\u760d\u30de\u30fc\u30ab\u30fc\u306f\u9670\u8ee2\u3057\u3066\u3044\u3066\uff0c\u3069\u3046\u898b\u3066\u3082\u5947\u5f62\u816b\u304c\u5316\u5b66\u7642\u6cd5\u306b\u3088\u308bparadoxical response\u3092\u751f\u3058\u305f\u3082\u306e\u3067\u3057\u305f\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u6d88\u3048\u3066\u5947\u5f62\u816b\u3060\u3051\u5897\u5927\u3059\u308b\u3068\u3044\u3046\u73fe\u8c61\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15245\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy4-300x293.jpg\" alt=\"\" width=\"300\" height=\"293\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy4-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy4-550x536.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy4-768x749.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy4.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15246\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy5-300x294.jpg\" alt=\"\" width=\"300\" height=\"294\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy5-300x294.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy5-550x540.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy5-768x754.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy5.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-15248\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/03\/germcelltumoroy6-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><br \/>\n\u307e\u305a\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u3066\uff0c\u6210\u719f\u671f\u5947\u5f62\u816b\u306e\u75c5\u7406\u8a3a\u65ad\u3092\u78ba\u5b9a\u3057\u307e\u3057\u305f\u3002\u305d\u308c\u304b\u3089ICE\u5316\u5b66\u7642\u6cd5\u3092\uff12\u30b3\u30fc\u30b9\u52a0\u3048\u3066\uff0c\u8133\u810a\u9ac4\u7167\u5c04 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