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早产儿先天性颅内未成熟畸胎瘤:病例报告。

Congenital intracranial immature teratoma in a preterm infant: illustrative case.

机构信息

Neurosurgery Department, Ibn Sina Hospital, Kuwait City, Kuwait.

Kuwait Institution of Medical Specialization (KIMS), Kuwait City, Kuwait.

出版信息

Childs Nerv Syst. 2024 Nov 27;41(1):4. doi: 10.1007/s00381-024-06666-4.

Abstract

BACKGROUND

Congenital intracranial immature teratoma is a rare tumor that is present in the first year of life. It is composed of three embryonic germ layers. These tumors are mainly manifested by hydrocephalus. Radiological investigations and histopathological studies are crucial to evaluating and diagnosing intracranial immature teratoma. Few cases were documented in the literature.

OBSERVATIONS

In this case, we highlight a preterm infant born with grade III proptosis and an intracranial space-occupying lesion that was diagnosed as high-grade congenital intracranial immature teratoma by brain MRI and histopathology studies. Neoadjuvant chemotherapy was used after the failure of the initial first attempt of craniotomy and lesion resection. Although, the tumor size increased post-chemotherapy, both intracranial and orbital parts of the lesion were excised efficiently with minimal blood loss, achieving complete tumor resection.

LESSONS

We demonstrate a case of a rare congenital brain tumor in the pediatric population. We report the diagnostic and treatment challenges besides the effective intraoperative role of neoadjuvant chemotherapeutic agents. To our knowledge, the current case is one of the few published cases of intracranial immature teratoma that presented with ophthalmic manifestations.

摘要

背景

先天性颅内未成熟畸胎瘤是一种罕见的肿瘤,发生于生命的第一年。它由三个胚胎层组成。这些肿瘤主要表现为脑积水。影像学检查和组织病理学研究对于评估和诊断颅内未成熟畸胎瘤至关重要。文献中很少有病例报道。

观察结果

在本例中,我们重点介绍了一例早产儿,出生时表现为 III 级眼球突出和颅内占位性病变,脑 MRI 和组织病理学研究诊断为高级别先天性颅内未成熟畸胎瘤。在首次开颅和病变切除失败后,使用了新辅助化疗。尽管化疗后肿瘤大小增加,但通过最小的失血,有效地切除了颅内和眼眶部分的病变,实现了肿瘤的完全切除。

教训

我们展示了一例儿科人群中罕见的先天性脑肿瘤病例。我们报告了诊断和治疗方面的挑战,以及新辅助化疗药物在术中的有效作用。据我们所知,目前的病例是少数几例以眼部表现为特征的颅内未成熟畸胎瘤病例之一。

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