Department of Respiratory Surgery, Nihon University School of Medicine, 30-1, Ohyaguchi-Kamicho, Itabashi-Ku, Tokyo, 173-8610, Japan.
Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Ohyaguchi-Kamicho, Itabashi-Ku, Tokyo, 173-8610, Japan.
J Cardiothorac Surg. 2022 Dec 22;17(1):333. doi: 10.1186/s13019-022-02091-3.
Mature teratomas are benign germ cell tumors. On rare occasions, they have been associated with somatic malignancies and are termed rare germ cell tumors with a somatic-type malignancy (GCTSM). Mature teratomas commonly comprise adenocarcinomas; only seven previous cases of mature teratomas with neuroendocrine tumors have been reported to date. Here, we report a patient with a neuroendocrine tumor whithin a mature teratoma.
A 26-year-old man visited our department complaining of chest tightness. Contrast-enhanced computed tomography (CT) scans showed a strongly enhanced lesion within a 10-cm encapsulated cystic lesion in the anterior mediastinum. Positron emission tomography (PET) scans showed no areas of significant F-fluorodeoxyglucose (F-FDG) accumulation. He underwent complete tumor resection via the transsternal approach. Histopathological examination of the specimen indicated a neuroendocrine tumor contained within a mature teratoma.
In this case, a neuroendocrine tumor was contained within a mature teratoma. Our patient had no specific symptoms and his serum markers were within the normal range. Although PET is beneficial for diagnosing other GCTSM, it is not useful in detecting a neuroendocrine tumor. Therefore, the preoperative diagnosis of neuroendocrine tumors contained within mature teratomas remains challenging. However, GCTSM should be suspected in patients exhibiting CT findings of a mediastinal tumor, measuring ≥ 6 cm, in addition to characteristic GCTSM findings. Moreover, surgery should be performed carefully in such cases.
成熟畸胎瘤是良性生殖细胞肿瘤。极少数情况下，它们与体细胞恶性肿瘤相关，被称为具有体细胞恶性肿瘤的罕见生殖细胞肿瘤（GCTSM）。成熟畸胎瘤通常包含腺癌；迄今为止，仅报告了 7 例以前的伴有神经内分泌肿瘤的成熟畸胎瘤病例。在此，我们报告了一例神经内分泌肿瘤合并成熟畸胎瘤的患者。
一名 26 岁男性因胸闷就诊于我院。增强 CT 扫描显示前纵隔一个 10cm 大的包膜性囊性病变内有一个明显强化的病灶。正电子发射断层扫描（PET）扫描未显示出明显的 F-氟代脱氧葡萄糖（F-FDG）摄取区域。他经胸骨正中入路行完全肿瘤切除术。标本的组织病理学检查显示，神经内分泌肿瘤位于成熟畸胎瘤内。
在本例中，神经内分泌肿瘤位于成熟畸胎瘤内。我们的患者没有特定的症状，且他的血清标志物在正常范围内。尽管 PET 有助于诊断其他 GCTSM，但对于检测神经内分泌肿瘤并不有用。因此，神经内分泌肿瘤位于成熟畸胎瘤中的术前诊断仍然具有挑战性。然而，对于表现为纵隔肿瘤、大小≥6cm 的 CT 发现，以及具有特征性 GCTSM 表现的患者，应怀疑 GCTSM。此外，对于此类病例应谨慎进行手术。
