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成熟型先天性脑室内颅内畸胎瘤:一例报告并文献复习

Mature congenital intraventricular intracranial teratoma: A case report and literature review.

作者信息

Nery Breno, Fernandes Raivson Diogo Felix, Nobrega Emanuella Arruda do Rego, da Silva Arthur Cellys Tavares, Liebig Maisa Souza, Nóbrega Clarissa Cartaxo Eloy, Braga Julia Lopes, Fernandes Thayna Dantas Souto, Quaggio Eduardo, De Sousa Segundo Jose Alencar

机构信息

Department of Neurosurgery, Hospital Beneficência Portuguesa de Ribeirão Preto, São Paulo, Brazil.

Unifacisa, Unifacisa-University Center, Department of Medicine, R. Manoel Cardoso Palhano, Campina Grande, Paraíba, Brazil.

出版信息

Surg Neurol Int. 2024 Jul 26;15:259. doi: 10.25259/SNI_289_2024. eCollection 2024.

Abstract

BACKGROUND

Intracranial teratomas represent a rare subset of neoplasms characterized by tissues derived from multiple germ layers within the cranial cavity. These tumors, originating from primordial germ cells, exhibit diverse clinical presentations and histopathological features. While predominantly located along the midline axis, including the suprasellar cistern and pineal region, they can also manifest in less common areas such as ventricles and hypothalamic regions. Histopathologically, they are classified as mature, immature, or malignant based on the degree of tissue differentiation.

CASE DESCRIPTION

Male patient with prenatal care for congenital hydrocephalus born at 38 weeks gestation with a bulging fontanelle. Postnatal imaging revealed an intraventricular lesion, later diagnosed through magnetic resonance imaging as a mature teratoma invading the lateral ventricle and extending to the hypothalamus. Surgical resection achieved total macroscopic removal followed by successful postoperative ventriculoperitoneal shunting due to evolving hydrocephalus.

CONCLUSION

Teratomas are uncommon tumors, and prognosis depends on tumor size and location, especially considering the rarity of mature teratomas. Complete surgical resection is paramount for treatment, leading to a better prognosis and quicker recovery. In cases where complete removal is challenging, adjuvant therapies and cerebrospinal fluid diversion may be required to enhance therapeutic outcomes and ensure successful resection.

摘要

背景

颅内畸胎瘤是一种罕见的肿瘤亚型,其特征是颅腔内存在来源于多个胚层的组织。这些肿瘤起源于原始生殖细胞,表现出多样的临床表现和组织病理学特征。虽然主要位于中线轴,包括鞍上池和松果体区域,但也可出现在脑室和下丘脑区域等不太常见的部位。在组织病理学上,根据组织分化程度,它们被分为成熟型、未成熟型或恶性型。

病例描述

一名男性患者,因先天性脑积水在孕期接受产前护理,孕38周出生,囟门膨隆。产后影像学检查发现脑室内病变,后来通过磁共振成像诊断为成熟畸胎瘤,侵犯侧脑室并延伸至下丘脑。手术切除实现了肉眼下完全切除,由于脑积水进展,术后成功进行了脑室腹腔分流术。

结论

畸胎瘤是罕见肿瘤,预后取决于肿瘤大小和位置,尤其是考虑到成熟畸胎瘤的罕见性。完整的手术切除对治疗至关重要,可带来更好的预后和更快的恢复。在完全切除具有挑战性的情况下,可能需要辅助治疗和脑脊液分流,以提高治疗效果并确保成功切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bb1/11302599/80fc9d5b101c/SNI-15-259-g001.jpg

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