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成人局部晚期腹膜后成熟畸胎瘤的根治性手术。病例报告。

Curative surgery for locally advanced retroperitoneal mature teratoma in an adult. Case report.

作者信息

Sarici Inanc Samil, Serin Kursat Rahmi, Agcaoglu Orhan, Akman Necip, Ucar Adem, Bilge Orhan

机构信息

Department of General Surgery, Istanbul University, Istanbul Medical School, Istanbul, Turkey.

出版信息

Int J Surg Case Rep. 2013;4(1):30-2. doi: 10.1016/j.ijscr.2012.08.017. Epub 2012 Sep 28.

Abstract

INTRODUCTION

Primary teratomas of retroperitoneum are not usual in the adult population. These tumors most commonly seen at the gonadal and sacrococcygeal regions. Herein we describe a case of an 18-year-old female who had a benign cystic teratoma at the retroperitoneum.

PRESENTATION OF CASE

The patient underwent an operation at another hospital following a misdiagnosis of hydatid cyst. The patient was referred to our hospital because of the detection of an unresectable tumor during her operation. A computerized tomography (CT)-angiography revealed a cystic mass, with a diameter of 14cm which was invaded into the retrohepatic suprarenal inferior vena cava and also extended to the posterior aspect of the liver. Additionally the mass invaded the posterior wall of the inferior vena cava and the right renal vein. The tumor was completely resected with a vascular resection. The inferior vena cava was reconstructed with a 12cm Dacron(®) graft and the renal vein was implanted. The patient's postoperative period was uneventful.

DISCUSSION

Germ cell tumors of retroperitoneum are usually seen in children, but there are also some reports of adult cases in the literature. Adult cases are especially seen in females. Imaging studies are paramount for diagnosis, preoperative strategy and safe surgical excision. CT scans and MRIs can identify various components of these tumors.

CONCLUSION

Even though primary retroperitoneal teratomas are quite rare in adults. Preoperative radiology imaging and strategy is critical for performing a safe surgery. The gold standard treatment strategy for this neoplasm is the surgical resection.

摘要

引言

原发性腹膜后畸胎瘤在成人中并不常见。这些肿瘤最常见于性腺和骶尾部区域。在此,我们描述一例18岁女性腹膜后良性囊性畸胎瘤的病例。

病例介绍

该患者在被误诊为包虫囊肿后于另一家医院接受了手术。由于在手术中发现了无法切除的肿瘤,患者被转诊至我院。计算机断层扫描(CT)血管造影显示一个直径为14cm的囊性肿块,侵犯了肝后肾上腺下腔静脉,并延伸至肝脏后方。此外,肿块侵犯了下腔静脉后壁和右肾静脉。通过血管切除将肿瘤完整切除。用一段12cm的涤纶移植物重建下腔静脉,并植入肾静脉。患者术后恢复顺利。

讨论

腹膜后生殖细胞肿瘤通常见于儿童,但文献中也有一些成人病例的报道。成人病例尤其多见于女性。影像学检查对于诊断、术前策略制定和安全的手术切除至关重要。CT扫描和磁共振成像(MRI)可以识别这些肿瘤的各种成分。

结论

尽管原发性腹膜后畸胎瘤在成人中相当罕见。术前放射学成像和策略对于进行安全的手术至关重要。该肿瘤的金标准治疗策略是手术切除。

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