Howman-Giles R, Holland A J A, Mihm D, Montfort J M, Arbuckle S, Kellie S
Department of Nuclear Medicine, The Children's Hospital at Westmead, The University of Sydney, Locked Bag 4001, Westmead, NSW 2145, Australia.
Pediatr Surg Int. 2008 Apr;24(4):475-8. doi: 10.1007/s00383-007-2006-7. Epub 2007 Sep 9.
A 6-year-old female presented with a subcutaneous sacral mass. Biopsy revealed an adenocarcinoma most likely arising from a sacrococcygeal teratoma (SCT). CT imaging revealed a massive tumour consistent with SCT. F(18)FDG Positron Emission Tomography (PET) scan confirmed marked metabolic activity in the tumour mass and regional lymph node involvement. After chemotherapy repeat CT and PET studies revealed a poor response but no evidence of peritoneal or distant metastases. Radical abdomino-pelvic and gluteal surgery was performed with removal of the entire tumour confirmed as a moderately differentiated adenocarcinoma arising in an immature teratoma. Follow up imaging including PET scanning 5 months after her surgery revealed widespread peritoneal, hepatic and pulmonary metastases. Somatic malignant transformation of an SCT in a child of this age has not been previously reported.
一名6岁女性因骶部皮下肿块就诊。活检显示为腺癌，很可能起源于骶尾部畸胎瘤（SCT）。CT成像显示有一个与SCT相符的巨大肿瘤。F(18)FDG正电子发射断层扫描（PET）证实肿瘤肿块及区域淋巴结受累处有明显的代谢活性。化疗后重复进行的CT和PET检查显示反应不佳，但无腹膜或远处转移的证据。进行了根治性腹盆腔和臀区手术，切除了整个肿瘤，证实为起源于未成熟畸胎瘤的中分化腺癌。术后5个月的随访成像包括PET扫描显示有广泛的腹膜、肝脏和肺部转移。此前未见有关于这个年龄段儿童SCT发生体细胞恶性转化的报道。
