Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Surgery, School of Medicine, Craniofacial and Cleft Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Am J Case Rep. 2021 Dec 24;22:e932752. doi: 10.12659/AJCR.932752.
BACKGROUND The central nervous system (CNS) is a rare point of origin for mature or immature teratomas. However, immature teratomas are extremely rare. CNS teratomas have been known for poor patient prognosis and recovery and also reduce survival. However, chemoradiotherapy has been reported to increase patient survival. CASE REPORT This study presents a rare giant immature teratoma invading a newborn infant's brain tissue and CNS. The tumor was surgically removed, and in a further 1-year follow-up, it did not need chemotherapy or radiotherapy according to alpha-fetoprotein (aFP) level and other serum markers. The teratoma had affected multiple loci of his brain's left hemisphere, including parietal, frontal, temporal, and occipital lobes. A teratoma was diagnosed lateral to the midline, which is not common in CNS teratomas, as they mainly occur in or near the midline. The tumor was excised completely. The patient was followed up for 1 year, and no further recurrence was observed. CONCLUSIONS Early diagnosis and treatment of immature teratomas are essential in patient prognosis. Chemotherapy is not always needed, but complete surgical removal and patient follow-up are always a necessity. In addition, adequate follow-up of these patients is critical to evaluate their further treatment plan and recurrence risk.
中枢神经系统(CNS)是成熟或未成熟畸胎瘤的罕见起源部位。然而,未成熟畸胎瘤极为罕见。CNS 畸胎瘤患者的预后和恢复较差,生存率也降低。然而,据报道,化疗和放疗可增加患者的生存率。
本研究报告了一例罕见的巨大未成熟畸胎瘤侵犯新生儿脑组织和 CNS 的病例。该肿瘤已通过手术切除,根据甲胎蛋白(aFP)水平和其他血清标志物,在进一步的 1 年随访中,患者无需进行化疗或放疗。该畸胎瘤已影响其左大脑半球的多个部位,包括顶叶、额叶、颞叶和枕叶。在中线的外侧诊断出一个畸胎瘤,这在 CNS 畸胎瘤中并不常见,因为它们主要发生在中线或其附近。肿瘤已完全切除。患者随访 1 年,未观察到进一步复发。
早期诊断和治疗未成熟畸胎瘤对患者的预后至关重要。并非总是需要化疗,但完整的手术切除和患者随访始终是必要的。此外,充分随访这些患者对于评估其进一步的治疗计划和复发风险至关重要。