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巨大右侧未成熟性颈部畸胎瘤继发上腔静脉综合征和缺氧缺血性脑病

Superior Vena Cava Syndrome and Hypoxic Ischemic Encephalopathy Secondary to a Massive, Right-Sided Immature Cervical Teratoma.

作者信息

Goldstein Nicolas Pn, Zhang Xin, Sollinger Christina, Chaturvedi Apeksha, Turri Riki, Mehta Rupal, Metlay Leon A, Katzman Philip J

机构信息

School of Medicine & Dentistry, University of Rochester Medical Center, Rochester, New York.

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

出版信息

Pediatr Dev Pathol. 2020 Mar-Apr;23(2):152-157. doi: 10.1177/1093526619865422. Epub 2019 Jul 23.

Abstract

Cervical teratomas are a rare form of fetal teratoma that can grow to massive size. Generally, these masses can be surgically excised after birth with excellent physical and functional prognosis because the benign variants respect anatomical borders. The primary complications of these masses are associated with compromise of the trachea and esophagus: upper airway obstruction and polyhydramnios. We report the first documented occurrence of superior vena cava syndrome and hypoxic ischemic encephalopathy associated with a massive, right-sided cervical teratoma. This case highlights that when cervical teratomas are right-sided and sufficiently large, they can extend inferiorly and compromise central venous return to the heart. This unique presentation would likely have required fetal surgical excision to avoid catastrophic cerebral injury.

摘要

颈部畸胎瘤是一种罕见的胎儿畸胎瘤,可生长至巨大体积。一般来说,这些肿块在出生后可通过手术切除,其身体和功能预后良好,因为良性变体尊重解剖边界。这些肿块的主要并发症与气管和食管受压有关:上呼吸道梗阻和羊水过多。我们报告了首例有记录的与巨大右侧颈部畸胎瘤相关的上腔静脉综合征和缺氧缺血性脑病。该病例突出表明,当颈部畸胎瘤位于右侧且足够大时,它们可向下延伸并影响心脏的中心静脉回流。这种独特的表现可能需要进行胎儿手术切除以避免灾难性的脑损伤。

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