Kagel T, Lemburg S P, Müller K-M, Laczkovics A, Nicolas V, Heyer C M
Institut für Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Universität Bochum.
Zentralbl Gynakol. 2006 Apr;128(2):90-4. doi: 10.1055/s-2006-921335.
We report on a 26-year old female patient with thoracic pain and dyspnea, in whom a large tumorous mass in the anterior mediastinum with a pleural effusion was diagnosed by computed tomography and magnetic resonance imaging. After rapid progression of tumor growth and detection of malignant cells within the pleural effusion operative intervention including resection of the tumor was performed. Histologic examination of the tumor revealed the typical morphology of a large mediastinal choriocarcinoma. The excessively high hCG-levels returned to normal values post-operatively. A thorough history making revealed an ectopic pregnancy which had made unilateral salpingectomy necessary. Although primary histologic examination of the tubarian tissue had shown no malignancy, a secondary look revealed a choriocarcinoma with identical histological features compared to the mediastinal tumor. Thus, final diagnosis of a mediastinal metastasis of a tubarian choriocarcinoma in ectopic pregnancy was made. We discuss this extremely rare disease and provide a short overview of the literature.
我们报告了一名26岁的女性患者,她有胸痛和呼吸困难症状,通过计算机断层扫描和磁共振成像诊断出前纵隔有一个伴有胸腔积液的巨大肿瘤性肿块。在肿瘤生长迅速进展且胸腔积液中检测到恶性细胞后,进行了包括肿瘤切除在内的手术干预。肿瘤的组织学检查显示为典型的巨大纵隔绒毛膜癌形态。术后过高的人绒毛膜促性腺激素(hCG)水平恢复到正常范围。详细的病史询问发现曾有异位妊娠,因此进行了单侧输卵管切除术。尽管最初对输卵管组织的组织学检查未发现恶性病变,但再次检查发现了与纵隔肿瘤具有相同组织学特征的绒毛膜癌。因此,最终诊断为异位妊娠输卵管绒毛膜癌纵隔转移。我们讨论了这种极为罕见的疾病,并对相关文献进行了简要综述。