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成熟囊性畸胎瘤,酷似脑脊膜膨出。

Mature cystic teratoma mimicking meningomyelocele.

机构信息

Department of Pathology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

Department of Neurosurgery, Faculty of Medicine, Kirikkale University, Yahsihan Yerleskesi, 71450, Kirikkale, Turkey.

出版信息

Childs Nerv Syst. 2021 Jul;37(7):2245-2249. doi: 10.1007/s00381-020-05017-3. Epub 2021 Jan 6.

Abstract

Teratomas are benign germ cell tumors originating from at least two germ layers, mostly of ectodermal and mesodermal origin. Mature teratomas are the most common subtype and develop from well-differentiated germ cells. Although the location is extragonadal in infants and young children, gonadal involvement occurs in adults. Midline defects can be diagnosed on prenatal imaging. In this case report, a newborn with mature cystic teratoma and a prenatal lumbar midline closure defect was presented. The perinatal preliminary diagnosis was meningomyelocele. However, a cystic sac containing exophytic solid tumoral tissues approximately 5 × 5 × 3 cm in size was seen macroscopically in the lumbar region after the birth, and this tumor was totally resected. After tumor excision, spina bifida aperta and vertebral exophytic bony tissue compatible with diastematomyelia were observed at the bottom of the surgical field and were totally resected. In the short-term follow-up, no additional problem occurred. The histopathological diagnosis was "mature cystic teratoma." In conclusion, extragonadal teratoma accompanying diastematomyelia could easily be mistaken for meningomyelocele or other common malformations. Perinatal diagnosis should be provided using radiodiagnostic methods, and total surgical excision and accurate pathological diagnosis are essential to avoid the risk of recurrence.

摘要

畸胎瘤是起源于至少两个胚层的良性生殖细胞肿瘤,主要来源于外胚层和中胚层。成熟型畸胎瘤是最常见的亚型,由分化良好的生殖细胞发育而来。尽管在婴儿和幼儿中肿瘤位于性腺外,但在成人中会发生性腺受累。中线上的缺陷可以在产前影像学中诊断。在本病例报告中,介绍了一例新生儿患有成熟囊性畸胎瘤和产前腰骶部中线闭合缺陷。围产期初步诊断为脊膜脊髓膨出。然而,在出生后在腰骶部可见一个约 5×5×3cm 大小的含有外生性实性肿瘤组织的囊性囊,该肿瘤被完全切除。肿瘤切除后,在手术野底部观察到开放性脊柱裂和与脊髓纵裂相符合的椎体外生性骨组织,并将其完全切除。在短期随访中,未出现其他问题。组织病理学诊断为“成熟囊性畸胎瘤”。总之,伴有脊髓纵裂的性腺外畸胎瘤容易误诊为脊膜脊髓膨出或其他常见畸形。应使用放射诊断方法提供围产期诊断,完全手术切除和准确的病理诊断对于避免复发风险至关重要。

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