Department of Obstetrics and Gynecology, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal.
Kathmandu Cancer Center, Changunarayan, Bhaktapur, Nepal.
JNMA J Nepal Med Assoc. 2023 Sep 1;61(265):727-730. doi: 10.31729/jnma.8267.
Immature teratoma is one of the rare malignant germ cell tumours presented in pregnancy. Here, we present 26-year-old pregnant women who had an incidental finding of left adnexal mass in an anomaly scan at 19 weeks of pregnancy. Laparotomy with peritoneal fluid cytology, left salpingo-oophorectomy and omental biopsy at 20 weeks of pregnancy revealed immature teratoma stage 1A, grade 2 in the histopathology report. However, she followed up with the metastatic mass in the pouch of Douglas at 30 weeks of pregnancy in magnetic resonance imaging despite being counselled for possible chemotherapy and surveillance. A baby with a good Apgar score and grade 3 immature teratoma in the metastatic mass was revealed following the exploratory laparotomy and cesarean section at 36 weeks of pregnancy. Fertility-sparing surgery with chemotherapy during pregnancy for high-grade tumours may result in a good prognosis.
case reports; chemotherapy; immature teratoma; pregnancy; surgery.
摘要：未成熟畸胎瘤是妊娠中罕见的恶性生殖细胞肿瘤之一。本文报道了一位 26 岁的孕妇，在妊娠 19 周的超声检查中偶然发现左侧附件肿块。在妊娠 20 周时行剖腹手术、腹腔液细胞学检查、左侧输卵管卵巢切除术和网膜活检，组织病理学报告显示为 1A 期、2 级未成熟畸胎瘤。然而，尽管接受了可能的化疗和监测咨询，但她在妊娠 30 周时磁共振成像显示在Douglas 窝有转移性肿块。在妊娠 36 周行剖腹探查和剖宫产术时，发现婴儿的阿普加评分良好，转移性肿块为 3 级未成熟畸胎瘤。对于高级别肿瘤，妊娠期间行保留生育功能的手术联合化疗可能会有较好的预后。
关键词：病例报告；化疗；未成熟畸胎瘤；妊娠；手术
