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INTRODUCTION: Spinal tumors (ST) often result in dire prognosis, carrying risks such as permanent paralysis, sensory loss, and sphincter dysfunction. Data on their incidence and etiology in pediatric populations are markedly scant. Our study investigates the etiology, clinical manifestation, treatment, and outcomes of pediatric ST. METHODS: We conducted a retrospective review of our institutional pediatric oncology and neurosurgery database, examining 14 patients under 18 years admitted with ST due to oncological diseases since 2005. We analyzed the clinical presentations, evaluations, molecular diagnostics and treatments for these patients. RESULTS: The study spanned 15 years and included 14 pediatric patients, each diagnosed with distinct spinal tumor entity. The mean patient age was approximately 19.6 ± 10.1 months. Severe axial pain along the vertebral column was observed in 13 patients, while acute neurological deterioration manifested in 7 patients. As a first-line intervention, 13 patients underwent decompressive surgery through laminectomy and tumor resection, and only one patient received chemotherapy solely. Before surgery, seven patients were unable to walk; post-surgery, six of them regained their ability to ambulate. The diagnosis encompassed a range of neoplasms: two instances of Ewing sarcoma, 3 instances of teratoma, one case presenting an atypical teratoid Rhabdoid tumor, two instances each of low-grade astrocytoma and neuroblastoma, and single instances of ependymoma, meningioma, rhabdomyosarcoma, and embryonal tumors with multilayered rosettes (ETMRs). Three patients succumbed two years after initiating therapy. CONCLUSION: Despite their rarity, intraspinal tumors in pediatric patients pose substantial therapeutic challenges. The intertwined complexities of the disease entity and the patient's neurological status demand swift initiation of an individualized therapeutic strategy. This crucial step helps optimize outcomes for this patient cohort, who frequently grapple with debilitating health conditions. Inclusion of these patients within a registry is mandatory to optimize treatment outcomes due to their rarity in pediatric population.
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Neoplasias de la Columna Vertebral , Humanos , Masculino , Femenino , Estudios Retrospectivos , Preescolar , Niño , Lactante , Adolescente , Resultado del Tratamiento , Neoplasias de la Columna Vertebral/cirugía , Neoplasias de la Columna Vertebral/complicaciones , Sarcoma de Ewing/cirugía , Sarcoma de Ewing/terapia , Sarcoma de Ewing/complicaciones , Neoplasias de la Médula Espinal/cirugía , Neoplasias de la Médula Espinal/complicaciones , Ependimoma/terapia , Ependimoma/cirugía , Ependimoma/diagnóstico , Laminectomía , Descompresión Quirúrgica/métodos , Teratoma/complicaciones , Teratoma/cirugía , Teratoma/diagnóstico , Teratoma/terapia , Procedimientos Neuroquirúrgicos/métodos , Neuroblastoma/cirugía , Neuroblastoma/complicaciones , Astrocitoma/complicaciones , Astrocitoma/cirugía , Astrocitoma/terapia , Tumor Rabdoide/terapia , Tumor Rabdoide/complicaciones , Meningioma/cirugía , Meningioma/terapia , Meningioma/complicaciones , Meningioma/diagnósticoRESUMEN
OBJECTIVE: To evaluate the impact of adjuvant chemotherapy, type of ovarian surgery, and the surgical approach on fertility in patients with stage I immature teratoma of the ovary. METHODS: Clinicopathologic data were retrospectively collected and analyzed from a cohort of 47 patients with childbearing desire treated for a stage I immature teratoma of the ovary at IRCCS San Gerardo dei Tintori Hospital, Monza, Italy. Multivariate logistic regression was used to address the influence of chemotherapy and type of surgery on the outcome. RESULTS: Among the patients included, 78.7% (37/47) were able to get pregnant, with a live birth rate of 80.9% (51/63 pregnancies). These rates were not different between adjuvant chemotherapy versus surveillance group (62.5% (5/8) and 82.0% (32/39), respectively; p=0.22) nor between the type of ovarian surgery (cystectomy vs unilateral salpingo-oophorectomy; p=0.57) and surgical approach (laparotomy or laparoscopy; p=0.18). A statistically significant difference was found for stage of disease (a decrease in pregnancy rate from 86.5% (32/37) for stage IA to 50.0% for stage IC (5/10); p=0.02), but it was not confirmed in the multivariate analysis. After relapse diagnosis and management, a total of 62.5% (5/8) of patients conceived and had at least one live birth baby. CONCLUSIONS: The fertility-sparing approach is feasible in this population, and fertility does not depend on surgical approach or post-operative treatment. However, adjuvant chemotherapy should be carefully evaluated in this setting.
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Estadificación de Neoplasias , Neoplasias Ováricas , Teratoma , Humanos , Femenino , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Adulto , Estudios Retrospectivos , Embarazo , Teratoma/cirugía , Teratoma/patología , Adulto Joven , Quimioterapia Adyuvante , Fertilidad , Adolescente , Preservación de la Fertilidad/métodos , Índice de EmbarazoRESUMEN
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Neoplasias Ováricas , Teratoma , Humanos , Teratoma/diagnóstico por imagen , Teratoma/complicaciones , Teratoma/cirugía , Femenino , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/cirugía , Torsión Ovárica/diagnóstico por imagen , Torsión Ovárica/complicaciones , Ultrasonografía/métodos , Diagnóstico Diferencial , Ovario/diagnóstico por imagen , AdultoRESUMEN
This is a rare case of struma ovarii combined with sarcomatoid carcinoma. Because struma ovarii and ovarian sarcomatoid carcinoma have an extremely low incidence, this may be the first case of a combined occurrence of both. Therefore, this report describes its clinical manifestations, diagnosis, and treatment, analyzes the pathogenesis, and summarizes the previous literature in the hope that it can be helpful to other tumor-related medical personnel and provide material support for the formation of guidelines for this disease.
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Neoplasias Ováricas , Estruma Ovárico , Teratoma , Humanos , Femenino , Estruma Ovárico/diagnóstico , Estruma Ovárico/patología , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/patología , Teratoma/diagnóstico , Teratoma/cirugía , Teratoma/patología , Teratoma/diagnóstico por imagen , Persona de Mediana Edad , Carcinosarcoma/diagnóstico , Carcinosarcoma/patología , AdultoRESUMEN
BACKGROUND: Video-assisted thoracic surgery (VATS) is widely used for thoracic lesions in pediatric patients. VATS is also applied to pediatric mediastinal tumors if there is no adhesion or invasion between the tumor and adjacent neuronal and cardiovascular structures. Here, we present a pediatric case of mediastinal teratoma in which the tumor adhered to the superior vena cava, and resection was safely completed using assisted VATS, an integrated surgical approach comprising mini-thoracotomy with video assistance. CASE PRESENTATION: A 9 year-old girl presented with right shoulder pain. Chest radiography and computed tomography revealed a 5.4 × 5.1 × 5.8 cm mass in the right upper anterior mediastinum. She was presumed with a mature teratoma, and resection was performed by assisted VATS with muscle sparing axillar skin crease incision (MSASCI) for a mini-thoracotomy. The procedure was safely completed, with the patient discharged on postoperative day 5. At 1 year postoperatively, there was no recurrence with excellent motor and cosmetic results. CONCLUSIONS: The combination of MSASCI and VATS would be useful not only for mediastinal teratomas but also for other mediastinal tumors and almost all other thoracic lesions in pediatric patients.
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Neoplasias del Mediastino , Teratoma , Cirugía Torácica Asistida por Video , Humanos , Neoplasias del Mediastino/cirugía , Neoplasias del Mediastino/diagnóstico por imagen , Teratoma/cirugía , Teratoma/diagnóstico por imagen , Femenino , Cirugía Torácica Asistida por Video/métodos , Niño , Tomografía Computarizada por Rayos X , Toracotomía/métodosRESUMEN
Mediastinal mature cystic teratomas are rare benign germ cell tumors that predominantly affect children. Despite their low incidence, they present unique diagnostic and management challenges. Early recognition and appropriate surgical intervention are crucial for optimal outcomes. This case report aims to highlight the importance of prompt diagnosis and management of mediastinal mature cystic teratomas in pediatric patients. We present the case of a 10-year-old female patient who presented with persistent chest pain and dyspnea. Imaging studies, including a chest X-ray and contrast-enhanced chest CT scan, revealed a large, well-circumscribed anterior mediastinal mass with calcifications. The patient underwent a right thoracotomy, resulting in the excision of a 6 × 5 × 5 cm mature cystic teratoma. Histopathological examination confirmed the diagnosis. The patient had an uneventful recovery and was discharged in stable condition. Mediastinal mature cystic teratomas pose diagnostic challenges due to their nonspecific symptoms and heterogeneous imaging characteristics. Differential diagnosis includes other mediastinal masses containing fat and calcifications. Surgical excision is the preferred treatment, although complete removal can be challenging due to adhesions to neighboring structures. Close follow-up is necessary to monitor for recurrence and complications. Mediastinal mature cystic teratomas are rare tumors with variable clinical presentations. Early detection and surgical intervention are crucial for optimal outcomes. These tumors should be included in the list of differential diagnoses for mediastinal masses in pediatric patients.
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Neoplasias del Mediastino , Teratoma , Tomografía Computarizada por Rayos X , Humanos , Teratoma/cirugía , Teratoma/diagnóstico por imagen , Teratoma/diagnóstico , Teratoma/patología , Femenino , Neoplasias del Mediastino/cirugía , Neoplasias del Mediastino/patología , Neoplasias del Mediastino/diagnóstico , Neoplasias del Mediastino/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Toracotomía , Dolor en el Pecho/etiología , Mediastino/patología , Mediastino/diagnóstico por imagen , Mediastino/cirugíaRESUMEN
Testicular germ cell tumours (GCTs) account for the majority of testicular malignancies. Seminomas and nonseminomas differ in prognosis and management strategies. While cisplatin-based chemotherapy has significantly improved survival rates, identification of residual masses after chemotherapy is crucial for determining further treatment and survival. For seminomas, spontaneous resolution of residual masses occurs in a significant percentage of cases. Fluorodeoxyglucose positron emission tomography (FDG PET) is recommended for evaluation of residual masses after chemotherapy. Retroperitoneal lymph node dissection (RPLND) offers therapeutic benefits but is challenging because of an increase in desmoplasia after chemotherapy. For nonseminomas, residual masses are common after chemotherapy, with surgical resection necessary for masses larger than 1 cm. FDG PET has limited utility, and timely surgical intervention is crucial for favourable outcomes. Teratoma, if left unresected, can lead to serious complications, including growing teratoma syndrome, malignant transformation, and late relapse. Extraretroperitoneal residual masses, particularly those containing teratoma, are associated with poorer prognosis. Surgical resection remains the mainstay treatment, with significantly higher progression-free and recurrence-free survival rates for fibrosis/necrosis in comparison to teratoma or viable cancer. Understanding the characteristics and management of residual masses after chemotherapy is paramount for optimising treatment strategies and improving patient outcomes in testicular GCT. PATIENT SUMMARY: We reviewed treatment options for patients with testicular cancer who still have tumour tissue in the lower abdomen after chemotherapy. Surgical removal of the tumour is the main option; removal of lymph nodes can also help, but may be difficult because of tissue reactions to chemotherapy. Survival rates differ according to the tumour type and are lower for tumours beyond the lower abdomen.
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Neoplasias de Células Germinales y Embrionarias , Neoplasias Retroperitoneales , Neoplasias Testiculares , Humanos , Neoplasias Testiculares/terapia , Neoplasias Testiculares/patología , Masculino , Neoplasias Retroperitoneales/terapia , Neoplasias de Células Germinales y Embrionarias/terapia , Neoplasias de Células Germinales y Embrionarias/patología , Seminoma/terapia , Seminoma/patología , Seminoma/cirugía , Escisión del Ganglio Linfático , Teratoma/terapia , Teratoma/cirugía , Neoplasia ResidualRESUMEN
BACKGROUND: Giant anterior mediastinal masses in infants are one of the most challenging cases faced in pediatric anesthesia practice. They can pose unique challenges for resection such as cardiovascular collapse on induction of anesthesia and injury to surrounding structures that maybe compressed or displaced. Principles that must be followed and kept in mind during removal of giant mediastinal mass include appropriate diagnostic imaging to define mass extent, airway control during induction, a multidisciplinary team approach including cardiothoracic for sternotomy, cannulation to institute cardiopulmonary bypass, otolaryngology for rigid bronchoscopy, preservation of neurovascular structure, and complete resection whenever possible. Our patient had a mass that weighed twice his whole body weight. CASE PRESENTATION: Here we present a 3-month-old Middle Eastern infant weighing 3.2 kg with a large congenital teratoma who presented to the emergency room with cyanosis and respiratory distress. During his hospital course, he underwent three procedures, two of them under light-to-moderate sedation: a diagnostic computer tomography scan followed by mass content drainage by interventional radiology (Figs. 1, 2). On the third day, he had a thoracotomy with complete tumor resection under general anesthesia with the help of an epidural for pain control (Fig. 3). The resected tumor weighed 2.5 kg, which was equal to twice the patient's total body weight (Fig. 4). After the surgery, he was extubated in the operating room and discharged home 3 days later. Fig. 1 Anterior-posterior chest x-ray showing the anterior mediastinal mass (AMM) Fig. 2 Cross-section computed tomography (CT) showing large anterior mediastinal mass (AMM) Fig. 3 Gross anatomy of the tumor before resection Fig. 4 Gross anatomy of the removed tumor CONCLUSION: Anterior mediastinal mass patients can be challenging for the anesthesiologist. They need meticulous thorough perioperative assessment to determine the extent of compression on major intramediastinal structures and to predict the complications. Planning by multidisciplinary team and discussion with the family is important. These types of cases should be preferably operated on by an experienced team in a well-equipped operation room in tertiary care institutes.
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Neoplasias del Mediastino , Teratoma , Humanos , Lactante , Masculino , Anestesia General/métodos , Neoplasias del Mediastino/congénito , Neoplasias del Mediastino/diagnóstico por imagen , Neoplasias del Mediastino/cirugía , Teratoma/congénito , Teratoma/diagnóstico por imagen , Teratoma/cirugía , Toracotomía/efectos adversos , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: The aim of this case report is to emphasize the significance of the growing teratoma syndrome. Growing teratoma syndrome is frequently misdiagnosed due to its low prevalence, with an estimated incidence of 19% among all immature ovarian teratomas and a lack of experience among healthcare professionals. It is characterized by the growth of benign tumoral tissue during or after chemotherapy for malignant germ cell tumors. CASE REPORT: Our case is about a 46-year-old patient diagnosed with an immature teratoma who was treated unsuccessfully with surgery and chemotherapy. The patient was then referred to our hospital for a second opinion, where this unknown entity was diagnosed and underwent complete surgical debulking, including abdominal wall resection and subsequent repair. CONCLUSION: Physicians need to be aware of rapidly growing masses during or after chemotherapy because early recognition of this syndrome is essential for the adequate treatment of our patients.
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Neoplasias Ováricas , Teratoma , Humanos , Teratoma/cirugía , Teratoma/diagnóstico , Femenino , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/cirugía , Persona de Mediana Edad , Síndrome , Procedimientos Quirúrgicos de CitorreducciónRESUMEN
INTRODUCTION: Teratoma is the most common congenital tumor, but the orbital location is rare. It is composed of tissues from ectoderm, mesoderm, and endoderm. CLINICAL PRESENTATION: Congenital orbital teratoma commonly presents as unilateral proptosis, with rapid growth, leading to exposure keratopathy. DIAGNOSIS: Prenatal ultrasound may detect the orbital mass, computed tomography (CT) scans, and magnetic resonance (MR) imaging are better in demonstrating multilocular cystic and solid mass, without bone erosion. Laboratory tests should include alfa-fetoprotein (AFP) and B-human chorionic gonadotropin (B-HCG), and histopathologically, it contains all three germ cell layers components. The management is surgical removal of the lesion, the mature teratoma has a benign behavior, and the immature has a poor prognostic. We describe a rare case of congenital orbital teratoma with intracranial extension of the lesion, in which was treated with orbital exenteration. After surgery, AFP levels decreased, the middle face displacement has improved and development milestones were appropriate.
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Neoplasias Orbitales , Teratoma , Humanos , Teratoma/cirugía , Teratoma/congénito , Teratoma/diagnóstico por imagen , Teratoma/patología , Neoplasias Orbitales/cirugía , Neoplasias Orbitales/congénito , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/patología , Imagen por Resonancia Magnética , alfa-Fetoproteínas/metabolismo , Tomografía Computarizada por Rayos X , Femenino , Masculino , Recién NacidoRESUMEN
OBJECTIVE: This study aims to examine the clinical characteristics and surgical management of pediatric testicular epidermoid cysts, thereby contributing to the existing body of knowledge pertinent to the diagnosis and therapeutic intervention s for this condition. METHODS: A retrospective analysis was conducted on the clinical records of 23 pediatric patients diagnosed with testicular epidermoid cysts, who were admitted to our institution between April 2013 and February 2024. Concurrently, a comprehensive review and analysis of pertinent literature were undertaken to augment the findings. RESULTS: The mean age at which the onset of epidermoid cysts was observed was 6.0 years. All cases were singular and unilateral. B-ultrasound diagnosis categorized 6 cases as epidermoid cysts, 11 as teratomas, and 6 as indeterminate, yielding a diagnostic sensitivity of 26.1%. All patients underwent testicle-sparing mass resection, and nine patients underwent rapid intraoperative frozen section analysis, revealing eight cases of testicular epidermoid cysts and one teratoma, with a diagnostic sensitivity of 88.89%. Postoperative histopathological examination confirmed the diagnosis of testicular epidermoid cyst. CONCLUSIONS: Pediatric testicular epidermoid cysts are an uncommon occurrence, primarily presenting as a painless scrotal mass, which can mimic the clinical features of malignant testicular tumors. Imaging modalities and histopathological assessment are pivotal in the diagnostic process for pediatric testicular epidermoid cysts. For cases where B-ultrasound is inconclusive, rapid intraoperative pathological examination should be considered.
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Quiste Epidérmico , Enfermedades Testiculares , Humanos , Masculino , Quiste Epidérmico/cirugía , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/diagnóstico por imagen , Estudios Retrospectivos , Niño , Preescolar , Enfermedades Testiculares/cirugía , Enfermedades Testiculares/diagnóstico , Enfermedades Testiculares/diagnóstico por imagen , Adolescente , Lactante , Testículo/diagnóstico por imagen , Testículo/cirugía , Testículo/patología , Ultrasonografía/métodos , Teratoma/cirugía , Teratoma/diagnóstico por imagen , Teratoma/diagnósticoRESUMEN
: Sacrococcygeal teratoma is a rare congenital malformation, the prognosis depends on factors affecting foetal development. The diagnosis is based on ultrasound examination, especially the evaluation of the detailed morphology of the foetus in the 20th week of pregnancy. Therefore, it is crucial to keep looking for ultrasound markers that would prenatally determine the most accurate prognosis for the foetus. Now, we rely on a small number of studies with a predominance of case reports. We offer a literature review of the essential information concerning sacrococcygeal teratoma diagnostics, therapy, and complications of sacrococcygeal teratomas in connection with prenatal diagnosis. It turns out that in cases with a favourable prognosis according to prenatal ultrasound examination and adequate surgical treatment after childbirth, the prognosis of this congenital malformation is excellent.
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Región Sacrococcígea , Teratoma , Ultrasonografía Prenatal , Humanos , Teratoma/diagnóstico por imagen , Teratoma/diagnóstico , Teratoma/cirugía , Femenino , Región Sacrococcígea/diagnóstico por imagen , Embarazo , PronósticoRESUMEN
OBJECTIVES: We present an Egyptian study on pediatric ovarian immature teratomas (ITs), aiming to clarify our treatment strategy selection. METHODS: A retrospective review of all children with pure ovarian ITs who were treated at our institution between 2008 and 2023. The analysis included clinical characteristics, tumor staging according to Children's Oncology Group (COG), grading based on the Norris system, management, and outcomes. RESULTS: Thirty-two patients were included, with a median age of 9 years. All patients underwent primary surgery. Unilateral salpingo-oophorectomy was performed in 31 patients. Surgical staging was completed in all patients. Based on COG staging, there were 28 patients (87.5%) stage I, 1 (3%) stage II, and 3 (9.5%) stage III. According to Norris classification, 16 patients (50%) were classified as grade I, 9 (28%) grade II, and 7 (22%) grade III. All patients in stage I were treated using surgery-alone approach, whereas the remaining four (12.5%) received adjuvant chemotherapy. Five patients in stage I had gliomatosis peritonei (GP), and none of them underwent extensive surgery. At a median follow-up of 86 months, two patients had events. The first patient (stage III/grade I) developed IT relapse on the operative bed, and the second (stage I/grade I) had a metachronous IT on the contralateral ovary. Both patients were successfully managed with surgery followed by second-line chemotherapy. Five-year overall survival and event-free survival for all patients were 100% and 93.4%, respectively. CONCLUSIONS: Surgery-alone strategy with close follow-up achieves excellent outcomes for localized ovarian ITs in children, irrespective of the Norris grading or the presence of GP. However, adjuvant chemotherapy is questionable for patients with incompletely resected or locally advanced tumors, and its role requires further evaluation through prospective multicentric studies with a larger sample size.
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Neoplasias Ováricas , Teratoma , Centros de Atención Terciaria , Humanos , Femenino , Teratoma/patología , Teratoma/terapia , Teratoma/cirugía , Teratoma/mortalidad , Neoplasias Ováricas/patología , Neoplasias Ováricas/terapia , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/mortalidad , Estudios Retrospectivos , Niño , Estudios de Seguimiento , Adolescente , Pronóstico , Preescolar , Centros de Atención Terciaria/estadística & datos numéricos , Tasa de Supervivencia , Estadificación de Neoplasias , Quimioterapia Adyuvante/métodos , Lactante , Egipto/epidemiología , Salpingooforectomía/métodos , Manejo de la EnfermedadRESUMEN
Aim: Atypical teratoid rhabdoid tumor (ATRT) is a rare and highly aggressive primary CNS neoplasm, predominantly observed in children. The use of autologous stem cell transplantation (ASCT) in pediatric ATRT has shown promise; however, its utility in adult ATRT remains unclear. Patients & methods: This study presents the case of an adult patient with ATRT who is in remission after ASCT and reviews the literature on ASCT in adults with ATRT. Four cases of ATRT in adults who underwent ASCT were identified, with pertinent data summarized. Results: All five patients survived longer than the historical average survival rate, four of whom had no clinical or radiographic evidence of disease at the final follow-up. Conclusion: Based on limited data, there may be a role for ASCT in the treatment of adults with ATRT.
[Box: see text].
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Tumor Rabdoide , Teratoma , Trasplante Autólogo , Humanos , Tumor Rabdoide/terapia , Tumor Rabdoide/patología , Tumor Rabdoide/cirugía , Adulto , Teratoma/terapia , Teratoma/patología , Teratoma/cirugía , Trasplante de Células Madre/métodos , Masculino , Femenino , Neoplasias Encefálicas/terapia , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugíaRESUMEN
ABSTRACT: Currarino syndrome (CS) is a rare congenital syndrome characterized by a triad of anorectal malformation, sacral deformity, and presacral mass. In about 50% of cases, it is caused by HLXB9 gene mutation in chromosome 7q36. A 13-month-male child presented with presacral discharging sinus with a history of surgery for anorectal malformation and perineal fistula at the time of birth. On detailed investigation, the child revealed to have anal atresia, hemisacrum, and presacral mass. Histopathology of presacral mass showed features of immature teratoma. The presacral mass in CS is mostly an anterior myelomeningocele or presacral teratoma. The development of immature teratoma in presacral mass is very rare. The histopathological identification of immature component of teratoma in the presacral mass of CS is important for risk stratification and further management. Suspicion of CS should be raised in any child presenting with partial phenotype of the triad.
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Canal Anal , Anomalías del Sistema Digestivo , Recto , Sacro , Siringomielia , Teratoma , Humanos , Teratoma/patología , Teratoma/cirugía , Teratoma/diagnóstico , Masculino , Canal Anal/anomalías , Canal Anal/cirugía , Canal Anal/patología , Sacro/anomalías , Sacro/cirugía , Sacro/patología , Anomalías del Sistema Digestivo/cirugía , Anomalías del Sistema Digestivo/diagnóstico , Anomalías del Sistema Digestivo/patología , Anomalías del Sistema Digestivo/genética , Siringomielia/cirugía , Siringomielia/genética , Siringomielia/patología , Siringomielia/diagnóstico , Siringomielia/diagnóstico por imagen , Lactante , Recto/anomalías , Recto/cirugía , Recto/patología , Ano Imperforado/cirugía , Ano Imperforado/diagnóstico , Ano Imperforado/genética , Ano Imperforado/patologíaRESUMEN
We present a rare case of a 40-year-old nulliparous lady, with no past medical or surgical history, who was diagnosed with metastatic squamous cell carcinoma of the right ovary that originated from a mature cystic ovarian teratoma. Our patient underwent debulking total abdominal hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy followed by postoperative carboplatin and paclitaxel chemotherapy. Rapid disease progression ensued, complicated by severe parathyroid hormone-related protein-induced hypercalcaemia resistant to medical therapy. The patient was treated in a palliative manner and died five months after her diagnosis.
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Carcinoma de Células Escamosas , Hipercalcemia , Neoplasias Ováricas , Teratoma , Humanos , Femenino , Neoplasias Ováricas/patología , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/cirugía , Teratoma/complicaciones , Teratoma/cirugía , Hipercalcemia/etiología , Adulto , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Resultado Fatal , Histerectomía/métodos , Paclitaxel/uso terapéuticoRESUMEN
RATIONALE: Primary ovarian leiomyoma is a rare benign tumor. The exact histological origin and pathogenesis of primary ovarian leiomyoma are still unclear, while its preoperative imaging diagnosis is often challenging and prone to misdiagnosis. The study aims to elucidate the diagnosis of primary ovarian leiomyoma and to distinguish it from fibroma. PATIENT CONCERNS: A 34-year-old female was admitted to the hospital with complaints of pelvic mass found for one year. One years ago, the patient went to a local hospital for examination due to irregular menstruation. DIAGNOSES: The ultrasound report of the patient showed ovarian teratoma. The postoperative pathological results showed ovarian leiomyoma and calcification. INTERVENTIONS: The patient underwent laparoscopic right ovarian leiomyoma resection. OUTCOMES: The patient was discharged home three days after surgery. At the most recent follow-up (five months after operation) of the patients, ultrasound was performed and no abnormal echoes were suggested in the adnexal region. LESSONS: In the diagnosis of primary ovarian leiomyoma, our case emphasizes the importance of microscopic features as an effective approach to distinguish it from ovarian fibroma, leiomyosarcoma, and stromal tumors. Additionally, personalized treatment should be considered based on the patient age and fertility needs.
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Calcinosis , Leiomioma , Neoplasias Ováricas , Humanos , Femenino , Adulto , Leiomioma/patología , Leiomioma/diagnóstico por imagen , Leiomioma/cirugía , Leiomioma/diagnóstico , Neoplasias Ováricas/patología , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/cirugía , Calcinosis/patología , Calcinosis/diagnóstico por imagen , Calcinosis/diagnóstico , Diagnóstico Diferencial , Ultrasonografía/métodos , Teratoma/patología , Teratoma/diagnóstico por imagen , Teratoma/diagnóstico , Teratoma/cirugía , Laparoscopía/métodosRESUMEN
BACKGROUND Fetus in fetu (FIF), or parasitic fetus, is a rare malformation that typically occurs in the retroperitoneum, but can be found in other unusual locations, such as the skull, sacrum, and mouth. The presence of a spine is necessary for diagnosis. CASE REPORT Intracranial FIFs were retrospectively studied. Abnormalities were detected in the fetal head during a 33-week prenatal examination; however, MRI could not provide more information, due to space occupation. A baby girl was born via cesarean delivery at 37 weeks, with a large head circumference. She had delays in motor skills and speech development, only able to say "mom". There was a large mass in the cerebral hemisphere, with a 13-cm maximum diameter, smooth boundary, and internal bone structure visible on head CT scan. Both ventricles and third ventricle had hydrops, with a fetal shape at a continuous level, along with apparent compression near the cerebral parenchyma. After performing preoperative examinations, laboratory tests, and surgical planning, craniotomy was performed on the FIF, under general anesthesia. Following complete mass resection, mouth, eye, arm, and hand shapes could be observed. The patient was unconscious after surgery and had seizures that were difficult to control. She died 12 days after surgery. Teratomas can be distinguished based on anatomy and imaging. Surgical resection is the only curative treatment and its prognosis is poor. CONCLUSIONS Intracranial FIF cases are rare and require early diagnosis and surgical treatment. Differentiating between FIF and teratoma is crucial, and monitoring alpha-fetoprotein levels after surgery can help detect recurrence.
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Teratoma , Humanos , Femenino , Recién Nacido , Pronóstico , Teratoma/cirugía , Teratoma/diagnóstico por imagen , Teratoma/diagnóstico , Embarazo , Feto/cirugía , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/diagnóstico por imagen , Resultado Fatal , Craneotomía , Imagen por Resonancia Magnética , Adulto , Tomografía Computarizada por Rayos XRESUMEN
A Swiss mountain dog, ~3 y old, was brought to a veterinary clinic because of a progressive enlargement of the abdomen. Upon clinical examination, a large mass was detected. After surgical extraction, the mass was confirmed to be a large ovarian teratoma. The weight of the tumor was > 16% of the dog's overall body weight. The dog recovered fully after surgery. The observations from this case suggest that, although teratomas are rare, prompt and accurate diagnosis is necessary to prevent further growth of these masses and to ensure positive outcomes.
Tératome ovarien chez un chien de montage suisse. Un chien de montagne suisse âgé d'environ 3 ans a été présenté dans une clinique vétérinaire en raison d'une augmentation de volume progressive de l'abdomen. Lors de l'examen clinique, une grosse masse a été détectée. À la suite du retrait chirurgical, la masse a été confirmée comme étant un large tératome ovarien. Le poids de la masse tumorale était > 16 % du poids total du chien. Le chien a récupéré complètement après la chirurgie. Les observations à partir de ce cas suggèrent, bien que les tératomes soient rares, un diagnostic rapide et exact est nécessaire pour prévenir une croissance ultérieure de ces masses et assurer une issue positive.(Traduit par Dr Serge Messier).