Pause in sexual development

Introduction Sexual developmental pause is a clinical manifestation of embryonic germ cell tumors. The incidence of sexual developmental disorders in children under 15 years old is 10% to 37.5%. Thalamic damage can occur in diabetes insipidus, lethargy, obesity, developmental disorders, and sexual dysfunction.

Cause

Causes of sexual developmental pause

The etiology of germ cell tumors is not clear and family history is also very rare. It has been reported that in patients with Klinefelter syndrome (47, XXY, 47 chromosomes with 2 X and 1 Y sex chromosomes), the typical features of the patients in the mediastinum and intracranial germ cell tumors are small testicles, fine seminiferous glass. Change, no sperm, it is speculated that the occurrence of germ cell tumors in the mediastinum and intracranial is the variation of primordial genital wart differentiation leading to the change of germ cell migration and differentiation and its malignant tendency.

Frequent abnormalities in chromosomes in patients with germ cell tumors include non-random chromosome number abnormalities and structural ectopicities. In testicular germ cell tumors, 80% exhibit characteristic chromosomal structural abnormalities, chromosome 12 short arm and other arm chromosomal abnormalities (i12p), and many non-germ cell tumors and extragonadal germ cell tumors also have i12p malformations in embryos. During development, primordial germ cells are clearly visible at week 4 of the embryo, and they appear in the endoderm cells on the wall of the yolk sac near the site of the allantois. When the embryo begins to fold, the primordial germ cells migrate from the yolk sac wall through the posterior mesenteric of the hindgut to the genital wart, and enter the mesenchymal tissue to become the primitive cord, and then gradually develop into a mature gonad, which is the original in this migration process. Germ cells spread throughout the embryo, and when these migrating omnipotent stem cells do not complete normal evolution and stay, they are likely to become tumors. A more consistent view Germ cell tumor is a group of undifferentiated tumors derived from primordial germ cells.

an examination

Related inspection

Endocrine function test

Sexual development pause check

Laboratory inspection

1. In the blood of blood patients, chorionic gonadotropin alpha-fetoprotein and carcinoembryonic antigen can be elevated. It can return to normal after surgery and rise again when recurring or spreading. 11 cases of germ cell tumors were reported in China, and all patients had elevated levels of chorionic gonadotropin or alpha-fetoprotein in the blood. Therefore, most scholars believe that patients with elevated chorionic gonadotropin or alpha-fetoprotein have a poor prognosis.

2. Most patients with cerebrospinal fluid have increased pressure. In some patients, the protein content of cerebrospinal fluid is mildly moderately increased, and the chorionic gonadotropin or alpha-fetoprotein in cerebrospinal fluid can be significantly increased. Cystic cells can sometimes be found in cerebrospinal fluid cytology. Epithelioid cells can occur in cerebrospinal fluid in 70% of cases, but do not necessarily mean spinal cord metastasis.

Other auxiliary inspection

1. Skull flat film

Can show signs of increased intracranial pressure, 40% to 60% of patients may have abnormal calcification of the pineal gland, especially when calcification occurs in children aged 10 to 15 years, the calcification plaque diameter exceeds 1cm. Calcification down to the rear is a strong evidence for the diagnosis of germ cell tumors.

2. Radionuclide scanning

For continuous brain scintigraphy, most of the radionuclides were found to have a diameter greater than 1.5 cm in the tumor.

3.CT scan

CT scans accurately determine the size of the site and its surrounding relationships.

Plain CT can be seen with the same density or slightly higher density of gray matter in the brain. The incidence of granulosis of germ cell tumors in the pineal region is much higher than that in the saddle area. When the germ cell tumor grows in the pineal region, it is sometimes calcified. The pineal gland (in the form of a pellet) is wrapped in it, so the calcified "shot" may be in the tumor, or it may be pushed to the front side of the tumor, often on the side or the back. The shape of the tumor is circular or irregular, and the latter has a characteristic value in the diagnosis of germ cell tumors. The normal human pineal calcification rate is about 40%, and the pineal calcification rate of patients with germ cell tumor is nearly 100%; the saddle upper germ cell tumor can be free of calcification or fine calcification.

Differential diagnosis

Diagnosis is performed according to laboratory tests and auxiliary tests.

Sexual developmental pause and delayed development of sexual development

Delayed publication (delayedpuberty) refers to the girl 13 years old, the boy 14 years old has no puberty developmental manifestations, considered sexual developmental delay or lack of puberty development. If sexual signs appear at the beginning of puberty, slow development or stagnation is also attributed to developmental delay. Girls from the beginning of the development of the breast after 5 years of menstrual menarche, or boys can not develop maturity within 5 years after reaching the normal adult male level, should also be considered as sexual growth retardation.

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