Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100010, China.
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
BMC Med Imaging. 2022 Jul 14;22(1):125. doi: 10.1186/s12880-022-00848-9.
Malignant 'triton' tumor is an extremely rare subtype of malignant periphery nerve sheath tumors. Clinical diagnosis of malignant triton tumor is difficult before surgery due to its low incidence and the lack of knowledge. Therefore, to describe and summarize the CT imaging characteristics of malignant triton tumor is of great assistance for early and preoperative diagnosis.
Two cases suspected of MTT by CT scan before operation were closely observed. The diagnosis of malignant triton tumor was eventually confirmed by immunochemical assay, which verified speculation of CT scans. Huge, irregular, well-circumscribed lobulated mass-like shadows can be observed from these patients by CT scans. Besides, heterogeneity of density within the body of tumor was well-established by CT scans, together with linear septum. Meanwhile, CT scans demonstrated that calcifications were remarkable at the margin of tumor body.
Some CT image features from two cases were presented as a reference for the preoperative consideration of MTT: (i) enormity of mass-like shadow; (ii) presence of well-circumscribed lobulated shape; (iii) septum within the well-defined mass accompanied with hemorrhage, necrosis and cystic changes as well as calcification, especially within neurofibromatosis type 1 patients.
恶性“海妖”肿瘤是一种极其罕见的恶性外周神经鞘瘤亚型。由于发病率低且缺乏认识,恶性海妖肿瘤在手术前的临床诊断较为困难。因此,描述和总结恶性海妖肿瘤的 CT 成像特征对于早期和术前诊断有很大帮助。
术前 CT 扫描怀疑为 MTT 的 2 例患者,经密切观察,最终通过免疫化学检测诊断为恶性海妖肿瘤,证实了 CT 扫描的推测。CT 扫描可观察到患者的巨大、不规则、边界清楚的分叶状肿块样阴影。此外,CT 扫描显示肿瘤内部密度不均,伴线性间隔。同时,CT 扫描显示肿瘤体缘有明显的钙化。
本文提出了 2 例病例的一些 CT 图像特征,以供恶性海妖肿瘤术前考虑:(i)肿块样影巨大;(ii)边界清楚的分叶状形态;(iii)在明确的肿块内存在间隔,伴有出血、坏死、囊性变以及钙化,特别是在神经纤维瘤病 1 型患者中。