Srisupundit Kasemsri, Sukpan Kornkanok, Tongsong Theera, Traisrisilp Kuntharee
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand.
Department of Pathology, Faculty of Medicine, Chiang Mai University, Thailand.
J Clin Ultrasound. 2020 Sep;48(7):419-422. doi: 10.1002/jcu.22876. Epub 2020 Jun 7.
Mediastinal teratoma can cause severe hydrops fetalis, which worsens the effects of the mass compression on the vital mediastinal organs. A careful sonographic examination is mandatory to demonstrate the characteristic features suggestive of this congenital tumor. We describe these features at 20 weeks gestation. The most prominent finding was the heterogeneous echogenicity of a large cystic-solid mass with hyperechoic dots, seen as a part of the anterior mediastinum immediately posterior to the sternum. Additional diagnostic features included posterior displacement of the heart, low cardiac output, and hypoplasia of the normally structured heart and lungs due to the direct mass compression. These sonographic findings were confirmed at autopsy which confirmed a nonmetastatic immature teratoma. Sonography may enable accurate diagnosis of mediastinal teratoma considering the anterior location and heterogeneous appearance of the mass, posterior displacement of the heart, normal lung morphology, and compression effects on these organs.
纵隔畸胎瘤可导致严重的胎儿水肿，这会加重肿块对纵隔重要器官压迫的影响。必须进行仔细的超声检查以显示提示这种先天性肿瘤的特征性表现。我们描述了妊娠20周时的这些特征。最突出的发现是一个大的囊实性肿块具有高回声点，呈不均匀回声，该肿块位于胸骨后方紧邻前纵隔。其他诊断特征包括心脏向后移位、心输出量降低以及由于肿块直接压迫导致正常结构的心脏和肺发育不全。尸检证实了这些超声检查结果，确诊为非转移性未成熟畸胎瘤。考虑到肿块的前部位置、不均匀外观、心脏向后移位、正常的肺形态以及对这些器官的压迫效应，超声检查可能有助于准确诊断纵隔畸胎瘤。
