Luo Chih-Cheng, Huang Chen-Sheng, Chu Shih-Ming, Chao Hsun-Chin, Yang Chao-Ping, Hsueh Chuen
Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, 333, Taiwan.
Pediatr Surg Int. 2005 Jul;21(7):536-40. doi: 10.1007/s00383-005-1424-7. Epub 2005 May 26.
Retroperitoneal teratoma poses a significant problem in the differential diagnosis of Wilms' tumor, neuroblastoma, and other intraabdominal tumors. In an attempt to establish the best diagnostic and treatment modality, we reviewed our experience with retroperitoneal teratomas at a single institution in a 5-year period. Between January 1998 and December 2002, retroperitoneal teratomas were identified in 10 patients, seven females and three males, ranging from age 4 days to 12 years, with seven patients under the age of 1 year. The presence of calcifications or bony structure within the tumor was revealed on abdominal ultrasound study or computed tomography in nine of the 10 lesions. Total excision was performed in nine patients; another patient with grade III immature teratoma received postoperative chemotherapy besides excision. One patient with grade III immature teratoma who did not receive postoperative chemotherapy had a local recurrence 6 months later and was treated by repeated surgical excision and postoperative chemotherapy. All of these patients were free of disease at 8 months to 5 years of follow-up. Retroperitoneal teratomas were usually noted in patients under the age of 1 year. Though large, they are mostly benign lesions with no apparent connection to the retroperitoneal organs and are amenable to curative excision, but histologic evidence of grade III immature teratoma or malignancy demands aggressive postoperative chemotherapy to prevent local recurrence.
腹膜后畸胎瘤在肾母细胞瘤、神经母细胞瘤及其他腹腔内肿瘤的鉴别诊断中是一个重要问题。为了确定最佳的诊断和治疗方式，我们回顾了一家机构在5年期间内腹膜后畸胎瘤的诊治经验。1998年1月至2002年12月，共确诊10例腹膜后畸胎瘤患者，其中7例女性，3例男性，年龄从4天至12岁，7例患者年龄小于1岁。10个病灶中的9个在腹部超声检查或计算机断层扫描中显示肿瘤内有钙化或骨质结构。9例患者接受了肿瘤全切；另1例Ⅲ级未成熟畸胎瘤患者除手术切除外还接受了术后化疗。1例未接受术后化疗的Ⅲ级未成熟畸胎瘤患者在6个月后出现局部复发，接受了再次手术切除及术后化疗。所有这些患者在随访8个月至5年期间均无疾病复发。腹膜后畸胎瘤常见于1岁以下儿童。虽然肿瘤体积较大，但大多为良性病变，与腹膜后器官无明显关联，可通过手术治愈性切除，但Ⅲ级未成熟畸胎瘤或恶性肿瘤的组织学证据需要积极的术后化疗以防止局部复发。
