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一名21岁女性患者的纵隔和肝脏均出现未成熟畸胎瘤。

Immature teratoma in both mediastinum and liver of a 21-Year-old female patient.

作者信息

Cöl C

机构信息

Department of Surgery, Abant Izzet Baysal University Medical School, Bolu, Turkey.

出版信息

Acta Med Austriaca. 2003;30(1):26-8. doi: 10.1046/j.1563-2571.2003.02024.x.

Abstract

We present a case of an immature teratoma of the liver and the mediastinum. A 21-year-old female patient presented with dyspnea, abdominal pain, and abdominal mass. Abdominal ultrasonography showed a liver tumor which is located in the right lobe and composed of cystic and solid elements. Computed tomography (CT) also showed a big mass which contained multiple high density, nodular, semi-solid, heterogenic structures in the liver and another mass which contained multiple low density cystic lesions in the anterior mediastinum. Right thoraco-abdominal approach was performed on the patient and a complete macroscopic resection of tumors was achieved without complications. Both tumours were evaluated as having an intact capsule. The mediastinal tumour extended to the diaphragm on the right side, and is dissected from the 'surrounding lung, pericardium' and excised from diaphragm. Right hepatic lobectomy was performed for liver tumour. Intraoperative frozen sections of the liver tumor revealed teratoma. But the final pathological diagnosis was immature teratoma. Chemotherapy was given after surgery. The patient tolerated the procedure well and her postoperative course was unremarkable. At the first follow up 4 months after surgery she was alive and well and there was no evidence of recurrence, but the patient died within seven months with hepatic recurrence and spreading metastasis.

摘要

我们报告一例肝脏及纵隔未成熟畸胎瘤病例。一名21岁女性患者出现呼吸困难、腹痛及腹部肿块。腹部超声显示肝脏右叶有一肿瘤,由囊性和实性成分组成。计算机断层扫描(CT)还显示肝脏有一个大肿块,内含多个高密度、结节状、半实性、异质性结构,前纵隔还有另一个肿块,内含多个低密度囊性病变。对该患者实施了右胸腹联合入路手术,成功完整切除肿瘤,无并发症发生。两个肿瘤均被评估为有完整包膜。纵隔肿瘤延伸至右侧膈肌,从“周围肺、心包”分离并从膈肌切除。对肝脏肿瘤实施了右肝叶切除术。肝脏肿瘤术中冰冻切片显示为畸胎瘤。但最终病理诊断为未成熟畸胎瘤。术后给予化疗。患者对手术耐受良好,术后病程平稳。术后4个月首次随访时,她情况良好且无复发迹象,但患者在7个月内死于肝脏复发及广泛转移。

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