Rachwalik Maciej, Kosiorowska Kinga, Bochenek Maciej, Jasinski Marek, Przybylski Roman
Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
Int J Surg Case Rep. 2021 Mar;80:105680. doi: 10.1016/j.ijscr.2021.105680. Epub 2021 Feb 26.
The majority of mediastinal tumours develop asymptomatically and are often detected incidentally on a chest X-ray performed for another reason. Mediastinal tumours, although mostly asymptomatic, may cause non-specific symptoms associated with advanced tumour growth.
We present a case of a 30-year-old woman who presented with exhaustion and lower back pain accompanied by severe headaches with symptoms of visual disturbances, followed by the typical Horner syndrome. Computed tomography revealed a tumour measuring 12 × 11 × 10 cm in the right cavity with features suggestive of teratoma. The patient underwent mediastinal tumour resection and thymectomy. The pathomorphological examination confirmed the primary diagnosis of mediastinal teratoma, but rare somatic type malignancy was detected. Therefore, the patient was referred for further oncological treatment.
Mediastinal teratoma is an uncommon finding and usually asymptomatic. Despite its slow growth, it can grow enough to compress adjacent structures, causing symptoms similar to those presented in our patient.
Radiologic imaging proves diagnostic in most cases. Despite the somatic type malignancy, surgical excision of the tumour using the en-bloc technique seems to be a sufficient option for the patient, and further oncological treatment is not always obligatory.
大多数纵隔肿瘤无症状,常因其他原因进行胸部X线检查时偶然发现。纵隔肿瘤虽然大多无症状,但可能会出现与肿瘤进展相关的非特异性症状。
我们报告一例30岁女性患者,表现为疲惫、下背部疼痛,伴有严重头痛及视觉障碍症状,随后出现典型的霍纳综合征。计算机断层扫描显示右侧胸腔有一个大小为12×11×10 cm的肿瘤,特征提示为畸胎瘤。患者接受了纵隔肿瘤切除术和胸腺切除术。病理形态学检查证实了纵隔畸胎瘤的初步诊断,但发现了罕见的体细胞型恶性肿瘤。因此,患者被转诊接受进一步的肿瘤治疗。
纵隔畸胎瘤并不常见,通常无症状。尽管其生长缓慢,但仍可能长得足够大以压迫相邻结构,导致与我们患者相似的症状。
在大多数情况下,放射影像学检查具有诊断价值。尽管存在体细胞型恶性肿瘤,但采用整块切除技术对肿瘤进行手术切除似乎对患者来说是一个足够的选择,并非总是需要进一步的肿瘤治疗。