纵隔囊性畸胎瘤并发腺癌和鳞状细胞癌:1例报告及文献复习

Kun-Yun Yeh , Jie-Yu You , Chih-Ming Lin , Jyi-Jyh Hung , Chia-Wen Shih , Wen-Chi Chou , John W.-C. Chang , Jen-Seng Huang , Cheng-Hsu Wang
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引用次数: 0

摘要

畸胎瘤与恶性转化是罕见的在性腺或性腺外部位。性腺外畸胎瘤常发生于纵隔。超过三分之二的纵膈畸胎瘤伴恶性转化病例在诊断时接受化疗或放疗。在此,我们报告一个自然发生的纵隔畸胎瘤恶性转化在一个43岁的男子主诉胸闷和严重的呼吸困难。胸部电脑断层扫描发现一个巨大的囊性纵隔肿块。由于患者呼吸衰竭,急诊开胸手术切除肿瘤。肿瘤的组织学与囊性畸胎瘤一致,转化的非生殖细胞区显示腺癌和鳞状细胞癌。患者术后接受化疗。但病情迅速恶化,确诊后8个月死亡。总结以往文献报道:(1)纵膈畸胎瘤伴恶性转化患者经治疗后生存率为34.6%;(2)恶性成分为肉瘤和癌;存在这两种组织学特征的情况下,生存率相似,然而,多种或混合类型的恶性转化会降低生存率;(3)纵隔部位治疗诱导的畸胎瘤与自然发生的畸胎瘤之间的界限不清;(4)手术完全根除仍然是纵膈畸胎瘤恶性转化患者延长生存期的主要治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Simultaneous adenocarcinoma and squamous cell carcinoma arising from a mediastinal cystic teratoma: Case report and literature review

Teratoma with malignant transformation is rarely seen in gonadal or extra-gonadal sites. Extra-gonadal teratoma with malignant transformation is usually found in the mediastinum. More than two-thirds of mediastinal teratoma with malignant transformation cases receive chemotherapy or irradiation at the time of diagnosis. Herein, we report a naturally occurring mediastinal teratoma with malignant transformation in a 43-year-old man complaining of chest tightness and severe dyspnea. A huge cystic mediastinal mass was discovered from chest-computerized tomography scan. Emergent thoracostomy was performed to remove the tumor because of impending respiratory failure. The histology of the tumor was compatible with cystic teratoma, and the transformed non-germ cell region showed both adenocarcinoma and squamous cell carcinoma. The patient underwent postoperative chemotherapy. However, his condition deteriorated rapidly and he expired 8 months after diagnosis. Summarizing previous case reports in the literature: (1) 34.6% of mediastinal teratoma with malignant transformation patients survive after treatment; (2) the malignant components are sarcoma and carcinoma; similar survival rates are achieved where both histological features are present, however, survival is reduced with multiple or mixed types of malignant transformation; (3) the delineation between treatment-induced and naturally occurring teratoma with malignant transformation at the mediastinal site is indistinct; and, (4) complete surgical eradication is still the mainstay of treatment for prolonged survival in patients with mediastinal teratoma with malignant transformation.

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