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纵隔畸胎瘤与肺内支气管囊肿并存:一例报告

Coexistence of mediastinal teratoma and intrapulmonary bronchogenic cyst: a case report.

作者信息

Sadrizadeh Sepehr, Sadrizadeh Ali, Sadeghian Mohammad Hadi

机构信息

Department of Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Professor of Thoracic Surgery, Cardiothoracic Surgery and Transplant Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Med Case Rep. 2025 Jul 4;19(1):320. doi: 10.1186/s13256-025-05391-z.

Abstract

BACKGROUND

Mediastinal masses are relatively common in pediatric populations, but their coexistence with bronchogenic cysts is extremely rare. Such cases present diagnostic and therapeutic challenges owing to overlapping features and the need for precise identification to guide appropriate management. Reporting this unusual combination enhances awareness and contributes to the understanding of their clinical presentation and treatment.

CASE PRESENTATION

A 15-year-old female of Iranian ethnicity presented with a 3-month history of persistent, nonproductive cough unresponsive to standard medical treatments. The patient had no significant past medical history. Diagnostic imaging, including chest X-ray and computed tomography scans, revealed two separate thoracic lesions suggestive of mediastinal and pulmonary masses. The patient also underwent surgical resection via left posterolateral thoracotomy. Histopathological examination confirmed a mature cystic teratoma in the mediastinum, containing various tissue types, and an infected bronchogenic cyst within the lung, characterized by alveolar hemorrhage and abscess formation. Postoperative recovery was uneventful, and follow-up imaging demonstrated no residual abnormalities.

CONCLUSION

This case revealed the importance of comprehensive diagnostic evaluation in pediatric patients with persistent respiratory symptoms. Although rare, the simultaneous occurrence of mediastinal mature teratomas and bronchogenic cysts should be considered in differential diagnoses to enable timely surgical intervention. Recognizing this coexistence can lead to favorable outcomes and informs clinicians about the potential complexity of thoracic masses in adolescents.

摘要

背景

纵隔肿物在儿科人群中相对常见,但其与支气管源性囊肿并存极为罕见。由于特征重叠且需要精确识别以指导恰当管理,此类病例带来了诊断和治疗挑战。报告这种不寻常的组合可提高认识,并有助于理解其临床表现和治疗方法。

病例介绍

一名15岁的伊朗裔女性,有持续3个月的干咳病史,对标准药物治疗无反应。该患者既往无重大病史。包括胸部X光和计算机断层扫描在内的诊断性影像学检查显示有两个独立的胸部病变,提示纵隔和肺部肿物。患者还通过左后外侧开胸进行了手术切除。组织病理学检查证实纵隔内为成熟囊性畸胎瘤,包含多种组织类型,肺内为感染性支气管源性囊肿,其特征为肺泡出血和脓肿形成。术后恢复顺利,随访影像学检查未发现残留异常。

结论

该病例揭示了对有持续呼吸道症状的儿科患者进行全面诊断评估的重要性。尽管罕见,但在鉴别诊断时应考虑纵隔成熟畸胎瘤和支气管源性囊肿同时出现的情况,以便及时进行手术干预。认识到这种并存情况可带来良好预后,并让临床医生了解青少年胸部肿物的潜在复杂性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f06/12228267/63f98687a7d6/13256_2025_5391_Fig1_HTML.jpg

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