RESUMO
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.
Assuntos
Neoplasias Orbitárias , Teratoma , Humanos , Teratoma/cirurgia , Teratoma/congênito , Teratoma/diagnóstico por imagem , Teratoma/patologia , Neoplasias Orbitárias/cirurgia , Neoplasias Orbitárias/congênito , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia , Imageamento por Ressonância Magnética , alfa-Fetoproteínas/metabolismo , Tomografia Computadorizada por Raios X , Feminino , Masculino , Recém-NascidoRESUMO
This study described the pathological aspects of a mature intracranial teratoma with meningocele in a one-day-old lamb. The diagnosis of mature teratoma was based on microscopic features, where well-differentiated tissues representative of the three germ layers were observed. The tumor consisted of respiratory, gastrointestinal and urinary epithelium as components of the endoderm; muscle and bone tissues as components of the mesoderm; and keratinized stratified squamous epithelium and adnexa as components of the ectoderm. To the best of our knowledge, this is the first report of intracranial teratoma with meningocele in animals.(AU)
Descrevem-se os aspectos patológicos de um teratoma intracraniano benigno com meningocele em um cordeiro de um dia de idade. O diagnóstico de teratoma benigno foi baseado nos achados histopatológicos, com tecidos representativos das três camadas germinativas. O tumor consistia de epitélio respiratório, gastrintestinal e urinário como componentes do endoderma; tecido muscular e ósseo do mesoderma; e epitélio escamoso estratificado queratinizado e anexos como componentes do ectoderma. Com base no conhecimento dos autores, este é o primeiro relato de teratoma intracraniano com meningocele em animais.(AU)
Assuntos
Animais , Doenças dos Ovinos , Teratoma/veterinária , Meningocele/veterinária , Neoplasias Encefálicas/veterináriaRESUMO
ABSTRACT: This study described the pathological aspects of a mature intracranial teratoma with meningocele in a one-day-old lamb. The diagnosis of mature teratoma was based on microscopic features, where well-differentiated tissues representative of the three germ layers were observed. The tumor consisted of respiratory, gastrointestinal and urinary epithelium as components of the endoderm; muscle and bone tissues as components of the mesoderm; and keratinized stratified squamous epithelium and adnexa as components of the ectoderm. To the best of our knowledge, this is the first report of intracranial teratoma with meningocele in animals.
RESUMO: Descrevem-se os aspectos patológicos de um teratoma intracraniano benigno com meningocele em um cordeiro de um dia de idade. O diagnóstico de teratoma benigno foi baseado nos achados histopatológicos, com tecidos representativos das três camadas germinativas. O tumor consistia de epitélio respiratório, gastrintestinal e urinário como componentes do endoderma; tecido muscular e ósseo do mesoderma; e epitélio escamoso estratificado queratinizado e anexos como componentes do ectoderma. Com base no conhecimento dos autores, este é o primeiro relato de teratoma intracraniano com meningocele em animais.
RESUMO
Intracranial tumors are uncommon and represent 0.5-1.5 % of all pediatric tumors. Teratoma is the most frequent intracranial tumor found at birth. Large teratomas are extremely rare and have a guarded prognosis since they grow fast and cause brain tissue destruction. A 31-week primigravida was referred to our hospital for investigation of an intracranial mass seen in the fetus. Two-dimensional ultrasound showed a large heterogeneous solid mass with calcifications inside, measuring 5.3 × 4.8 cm. It was in the right cerebral hemisphere at the level of the middle and posterior fossa, thereby shifting the midline and causing severe ventriculomegaly that measured 3.5 cm at the level of the lateral ventricle. Three-dimensional ultrasound (3DUS) in multiplanar mode allowed us to assess the anatomical relationships between the mass and the midline structures. The neurosurgical team, who had suspected that the case was inoperable, was thus able to gain a better understanding of the case. Transfontanellar ultrasound was performed on the day after the birth and confirmed the previous findings. Moreover, a biopsy confirmed the histology of the mass: it was an immature teratoma. The infant died on the 24th day of life after a large expansion of head circumference. Intracranial teratomas are extremely severe because of their quick growth and mass effect, often leading to neonatal death within days. 3DUS is a new prenatal diagnostic method that makes it possible to assess the anatomical relationships between the mass and the intracranial structures, thus enabling better preoperative planning.