Hasbay Bermal, Canpolat Tuba, Aktekin Elif, Özkan Hasan, Demir Kekeç Şenay
Deparment of Pathology, Başkent University, Faculty of Medicine, Adana, Turkey.
Department of Pediatric Oncology, Başkent University, Faculty of Medicine, Adana, Turkey.
Turk Arch Pediatr. 2022 May;57(3):329-334. doi: 10.5152/TurkArchPediatr.2022.21306.
We aimed to evaluate the cases of sacrococcygeal germ cell tumors diagnosed in our hospital between 2006 and June 2021.
We evaluated 38 sacrococcygeal germ cell tumors cases in our series in terms of age, sex, clinical complaints, localization, macroscopy, tumor size, histopathological diagnosis, surgical, postoperative complications, treatment, recurrence, and prognosis.
The cases ranged from 1 day to 16 years of age; 14 cases were diagnosed with routine ultrasonographic examination during prenatal period while the rest of the cases most frequently presented with complaints of constipation. In terms of localization, 6 cases were type 1, 11 cases were type 2, 6 cases were type 3, and 15 cases were type 4. In the pathological evaluation, 25 cases were mature teratoma, 8 cases were immature teratoma, and 5 cases were pure yolk-sac tumor. In terms of complications, temporary colostomy was performed as a result of rupture during birth in 2 cases, disseminated intravascular coagulation at birth in 1 case, and colon injury in 2 cases. There was a recurrence in 2 of our cases. Thirty-seven of our cases were alive and 1 died. Alpha-fetoprotein level was high in 28 of our cases.
In our series, type 4 cases were observed more frequently, contrary to the literature. We recommend to use a routine ultrasonography to patients who come to the clinic with complaints of constipation and inability to urinate and if a mass is detected, asking for alphafetoprotein for further follow-up. Sacrococcygeal germ cell tumors are ultimately a disease that can be successfully treated with multidisciplinary approach, accurate diagnosis in the antenatal and postnatal period, appropriate surgical intervention, and regular follow-up.
我们旨在评估2006年至2021年6月期间在我院诊断的骶尾部生殖细胞肿瘤病例。
我们对本系列中的38例骶尾部生殖细胞肿瘤病例进行了年龄、性别、临床症状、定位、大体检查、肿瘤大小、组织病理学诊断、手术、术后并发症、治疗、复发及预后等方面的评估。
病例年龄范围为1天至16岁；14例在孕期通过常规超声检查确诊，其余病例最常见的症状是便秘。在定位方面，6例为1型，11例为2型，6例为3型，15例为4型。病理评估中，25例为成熟畸胎瘤，8例为未成熟畸胎瘤，5例为纯卵黄囊瘤。在并发症方面，2例因出生时破裂行临时结肠造口术，1例出生时发生弥散性血管内凝血，2例发生结肠损伤。我们的病例中有2例复发。37例存活，1例死亡。28例病例甲胎蛋白水平升高。
在我们的系列研究中，与文献报道相反，4型病例更为常见。我们建议对因便秘和排尿困难前来就诊的患者进行常规超声检查，若检测到肿块，检测甲胎蛋白以便进一步随访。骶尾部生殖细胞肿瘤最终是一种可通过多学科方法、产前和产后准确诊断、适当的手术干预及定期随访成功治疗的疾病。
