伴有早期复发和肺转移的巨大未成熟骶尾部畸胎瘤:病例报告

IF 0.2 Q4 PEDIATRICS
Kyoko Matsuki , Kenji Santo , Takashi Sasaki , Hiroyuki Fujisaki , Akihiro Yoneda
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引用次数: 0

摘要

导言:新生儿骶尾部畸胎瘤(SCT)如果与早产和组织学不成熟有关,则会导致不良后果。此外,有些患者还会复发,一般是在一到两年后。我们在此介绍一例早产儿未成熟 SCT 病例,该病例在首次切除后两个月内出现转移性复发。病例介绍一名早产儿在妊娠 28 周时出生,出生体重为 2337 克。出生后,患者出现贫血和凝血功能障碍,可能是由于瘤内出血,需要大量输血。手术切除是在患者出生12天时进行的。肿瘤经组织学诊断为未成熟畸胎瘤。甲胎蛋白(AFP)水平有所下降,但在术后第68天又有所上升。计算机断层扫描发现了局部复发和双侧肺转移。化疗期间,所有继发病灶均增大。我们切除了右肺的病灶,组织学诊断为成熟畸胎瘤。即使更换了化疗方案,残留病灶仍在进展。我们切除了左肺的病灶。经过另一个疗程的化疗,我们切除了骶骨前复发的肿瘤,经组织学确诊为成熟畸胎瘤。结论:本病例突出表明,未成熟骶尾部畸胎瘤最早可在初次切除后两个月复发和转移。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Giant immature sacrococcygeal teratoma with early recurrence and lung metastases: A case report

Introduction

Neonatal sacrococcygeal teratoma (SCT) results in poor outcomes if it is associated with preterm delivery and an immature histology. Furthermore, some patients experience recurrence, generally one to two years later. We herein present a preterm infant case of an immature SCT with metastatic recurrence within two months of the initial resection.

Case presentation

A neonate with prenatally diagnosed SCT was born at 28 weeks’ gestation with a birth weight of 2337 g. The tumor measured 18 × 9 × 8 cm in diameter, and it was predominantly solid and hypervascular. Postnatally, the patient presented with anemia and coagulopathy requiring a massive transfusion presumably due to intratumoral hemorrhage. Surgical resection was performed at 12 days of age. The tumor was histologically diagnosed to be an immature teratoma. The alpha-fetoprotein (AFP) levels decreased but increased thereafter on postoperative day 68. Computed tomography revealed both local recurrence and bilateral lung metastases. During chemotherapy, all secondary lesions were enlarged. We resected the lesion in the right lung, which was histologically diagnosed as mature teratoma. Even after switching chemotherapy protocols, the residual lesions were progressive. We resected the lesion from the left lung. Following another course of chemotherapy, we resected the presacral recurrent tumor, which was histologically confirmed as a mature teratoma. The patient has not shown any signs of a re-recurrence for 6 years.

Conclusion

This case highlights the fact that immature sacrococcygeal teratomas can recur and metastasize as early as two months after the initial resection.

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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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