Park Yejin, Lee Hyun Jin, Jung Yun Ji, Lee Joon Ho, Kwon Ja Young, Kim Young-Han
Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2018 Mar;61(2):278-281. doi: 10.5468/ogs.2018.61.2.278. Epub 2018 Jan 30.
Neuroblastoma is the most common pediatric extracranial solid tumor derived from primitive neural crest cells of the sympathetic nervous system. Although one-fifths of all neuroblastomas occurs within the thorax, thoracic neuroblastomas detected in fetus have been rarely reported. We report a case of fetal thoracic neuroblastoma with massive pleural effusion detected with prenatal ultrasonography. A 34-year-old Korean second-gravida was referred to our hospital at 30 weeks of gestation for evaluation, after the right lung mass found in the fetus. Approximately 3 cm, well-defined, hyperechoic mass was found in the right thorax with right pleural effusion, with the initial suspicion of teratoma. However, as mass continued to grow with deteriorating pleural effusion and fetal hydrops, the mass was considered malignant after 3 weeks. After a cesarean delivery, an approximately 4 cm mass with peripheral calcification and hemothorax was found on neonatal ultrasonography. Neuroblastoma was diagnosed on excision biopsy.
神经母细胞瘤是最常见的小儿颅外实体瘤,起源于交感神经系统的原始神经嵴细胞。尽管所有神经母细胞瘤中有五分之一发生在胸部,但胎儿期检测到的胸段神经母细胞瘤鲜有报道。我们报告一例产前超声检测到的伴有大量胸腔积液的胎儿胸段神经母细胞瘤病例。一名34岁的韩国经产妇在妊娠30周时因胎儿右肺肿物被转诊至我院评估。在胎儿右胸发现一个约3cm、边界清晰的高回声肿物,伴有右侧胸腔积液,最初怀疑为畸胎瘤。然而,随着肿物持续生长、胸腔积液恶化及胎儿水肿,3周后考虑该肿物为恶性。剖宫产术后,新生儿超声检查发现一个约4cm的肿物,伴有周边钙化和血胸。切除活检确诊为神经母细胞瘤。