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纯卵黄囊瘤,青春期后型,起源于隐睾。

Pure yolk sac tumour, post-pubertal type, arising from cryptorchid testes.

作者信息

Janugade Hemant, Monteiro Jeffrey, Gouda Shekhar

机构信息

General Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India.

出版信息

BMJ Case Rep. 2019 Jul 22;12(7):e229541. doi: 10.1136/bcr-2019-229541.

Abstract

Yolk sac tumour (YST), the most common germ cell tumour (GCT) in infants and children, accounts for 80% of GCTs in this age group. It is observed in only 2.4% of adult patients in their pure form since up to 42% of mixed GCTs have some component of the yolk sac. We present a 46-year-old cryptorchid man who presented with complaints of abdominal lump, pain and altered bowel habits since 1 month. CT scan of the abdomen revealed a mass arising from the pelvic cavity with feeders predominantly from the left gonadal vessel. Mass was excised via exploratory laparotomy and sent for histological examination. Microscopic examination was suggestive of pure YST. Immunohistochemistry stained positive for cytokeratin, placental-like alkaline phosphatase, Glypican 3 and alpha fetoprotein. The patient succumbed prior to commencing chemotherapy. Pure YSTs of post-pubertal origins are extremely rare and are more aggressive than their prepubertal counterparts.

摘要

卵黄囊瘤(YST)是婴幼儿中最常见的生殖细胞肿瘤(GCT),占该年龄组GCT的80%。其以单纯形式仅见于2.4%的成年患者,因为高达42%的混合性GCT含有卵黄囊成分。我们报告一名46岁的隐睾男性,自1个月前开始出现腹部肿块、疼痛及排便习惯改变的症状。腹部CT扫描显示盆腔有一肿块,供血血管主要来自左侧性腺血管。通过剖腹探查术切除肿块并送去做组织学检查。显微镜检查提示为单纯性YST。免疫组化显示细胞角蛋白、胎盘样碱性磷酸酶、磷脂酰肌醇蛋白聚糖3和甲胎蛋白呈阳性。该患者在开始化疗前死亡。青春期后起源的单纯性YST极其罕见,且比青春期前的同类肿瘤侵袭性更强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58c9/6663244/1092cf344f10/bcr-2019-229541f01.jpg

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