Peiró Jose L, Sbragia Lourenço, Scorletti Federico, Lim Foong Y, Shaaban Aimen
Cincinnati Fetal Center, Pediatric General and Thoracic Surgery Division, Cincinnati Children's Hospital Medical Center (CCHMC), University of Cincinnati, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA.
Pediatr Surg Int. 2016 Jul;32(7):635-47. doi: 10.1007/s00383-016-3892-3. Epub 2016 Apr 25.
Fetal teratomas are the most common tumors diagnosed prenatally. The majority of these tumors are benign and cured by complete resection of the mass during the neonatal period. Prenatal diagnosis has improved the perinatal management of these lesions and especially for the teratomas that might benefit from fetal intervention. A comprehensive prenatal evaluation including conventional ultrasounds, Doppler, echocardiography and fetal MRI, is essential for an effective counseling and perinatal management. Antenatal counseling helps the parents to better understand the natural history, fetal intervention, and perinatal management of these tumors, which differ dramatically depending on their size and location. Fetal surgical debulking improves survival in cases of sacrococcygeal teratoma with cardiac decompensation. Additionally, the use of an EXIT procedure reduces the morbidity and mortality if a complicated delivery in cases of cervical and mediastinal teratomas. Here, we offer an overview of all fetal teratomas and their recommended management, with emphasis on in utero treatment options.
胎儿畸胎瘤是产前诊断出的最常见肿瘤。这些肿瘤大多为良性，通过在新生儿期完整切除肿块即可治愈。产前诊断改善了这些病变的围产期管理，特别是对于可能受益于胎儿干预的畸胎瘤。包括传统超声、多普勒、超声心动图和胎儿磁共振成像在内的全面产前评估，对于有效的咨询和围产期管理至关重要。产前咨询有助于父母更好地了解这些肿瘤的自然病程、胎儿干预和围产期管理，这些会因其大小和位置的不同而有显著差异。对于伴有心脏代偿失调的骶尾部畸胎瘤，胎儿手术减瘤可提高生存率。此外，对于宫颈和纵隔畸胎瘤病例，如果分娩复杂，采用产时宫外治疗（EXIT）手术可降低发病率和死亡率。在此，我们概述了所有胎儿畸胎瘤及其推荐的管理方法，重点是宫内治疗方案。
