Wesolowski Agnieszka, Piazza Anthony
Department of Perinatal-Neonatal Medicine, Emory University, Atlanta, Georgia 30322, USA.
Am J Perinatol. 2008 Sep;25(8):507-12. doi: 10.1055/s-0028-1083836. Epub 2008 Aug 28.
This article reviews the current literature of mediastinal tumors as the cause of nonimmune hydrops fetalis (NIHF), the outcomes of reported cases, and a general overview of NIHF including diagnosis, workup, and a management algorithm, with particular attention made to intrathoracic lesions and gestation age. We present a unique case report of a premature neonate who initially presented with NIHF at birth and was subsequently diagnosed with a germ cell mediastinal teratoma as the etiology of NIHF. The patient survived for 50 days while having undergone surgical resection and chemotherapy during the hospital course. The patient represents the first reported case of a mediastinal tumor as the etiology of NIHF in the neonatal period and only one of three cases that have been reported to survive in the neonatal period. Survival is dependent on the thoracic lesion's size, location, resectability, impact on the growth and development of other vital organs, and in the case of tumors, malignant potential. Though the combination of mediastinal teratoma and NIHF is rare, it should be included in the diagnostic evaluation of a newborn with NIHF.
本文回顾了作为非免疫性胎儿水肿（NIHF）病因的纵隔肿瘤的当前文献、报告病例的结果，以及对NIHF的概述，包括诊断、检查和管理算法，特别关注胸腔内病变和孕周。我们报告了一例独特的病例，一名早产新生儿出生时最初表现为NIHF，随后被诊断为生殖细胞纵隔畸胎瘤，这是其NIHF的病因。该患者在住院期间接受了手术切除和化疗，存活了50天。该患者是新生儿期首例报告的以纵隔肿瘤为NIHF病因的病例，也是新生儿期报告存活的三例病例之一。生存取决于胸腔病变的大小、位置、可切除性、对其他重要器官生长发育的影响，以及肿瘤的恶性潜能。尽管纵隔畸胎瘤与NIHF的组合罕见，但在对患有NIHF的新生儿进行诊断评估时应将其纳入考虑。
