Kawai Momotaro, Nagoshi Narihito, Iwanami Akio, Mikami Shuji, Tsuji Osahiko, Fujita Nobuyuki, Yagi Mitsuru, Watanabe Kota, Ishii Ken, Nakamura Masaya, Matsumoto Morio
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Koga Hospital Spine Center, Ibaraki, Japan.
BMJ Case Rep. 2018 Sep 1;2018:bcr-2017-223742. doi: 10.1136/bcr-2017-223742.
A 23-year-old man presented with difficulty walking and leg pain and numbness. MRI revealed a cystic mass at Th11-12 and a pineal-region tumour. The patient underwent surgery to resect the thoracic-level mass. The tumour adhered strongly to the neural tissue and could only be partially resected. On pathological examination, the resected tumour was diagnosed as a mature teratoma. The tumour regrew and disseminated within 3 months after resection. Both the spinal cord tumour and the tumour in the pineal region shrank significantly after chemotherapy and radiotherapy. Although the tumour was pathologically diagnosed as a mature teratoma, we suspect that the residual tumour contained an immature or malignant component. Thus, careful follow-up observation is mandatory after partial resection of a mature teratoma. In addition, because teratomas can disseminate in the central nervous system, the presence of teratoma should prompt an examination of both the spinal cord and brain.
一名23岁男性因行走困难、腿部疼痛和麻木前来就诊。磁共振成像（MRI）显示胸11 - 12水平有一个囊性肿块以及松果体区肿瘤。患者接受了手术以切除胸段肿块。肿瘤与神经组织紧密粘连，只能部分切除。病理检查显示，切除的肿瘤被诊断为成熟畸胎瘤。肿瘤在切除后3个月内复发并扩散。化疗和放疗后，脊髓肿瘤和松果体区肿瘤均明显缩小。尽管肿瘤在病理上被诊断为成熟畸胎瘤，但我们怀疑残留肿瘤含有不成熟或恶性成分。因此，成熟畸胎瘤部分切除后必须进行仔细的随访观察。此外，由于畸胎瘤可在中枢神经系统扩散，发现畸胎瘤时应同时检查脊髓和脑部。
