Gilcrease M Z, Brandt M L, Hawkins E P
Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, USA.
J Pediatr Surg. 1995 Jun;30(6):875-7. doi: 10.1016/0022-3468(95)90770-x.
Although the predictive value of immature elements in sacrococcygeal teratomas in unclear, there are reports of malignant recurrence after surgical resection of immature sacrococcygeal teratomas. The recurrent tumors are presumed to arise from small residual malignant foci not identified at the time of surgical resection. In this report a premature female infant was delivered at 29 week's gestation with a large sacrococcygeal teratoma. The tumor weighed 1,350 g. It was largely cystic with a focal nodular and variegated appearance. Histologically, the tumor was a grade 1 immature teratoma with a predominance of neuroglial elements. No malignant elements were identified in any of 26 sections examined. The infant died intraoperatively of cardiovascular complications related to the large vascular supply of the tumor but had a grossly complete resection of tumor. At autopsy, a small microscopic focus of yolk sac tumor was identified adjacent to the sacrum anteriorly. Had the infant survived, this focus might well have been a source for malignant recurrence.
尽管骶尾部畸胎瘤中不成熟成分的预测价值尚不清楚，但有报告称，不成熟骶尾部畸胎瘤手术切除后会出现恶性复发。推测复发性肿瘤源于手术切除时未发现的小的残留恶性病灶。在本报告中，一名早产女婴在妊娠29周时分娩，患有巨大骶尾部畸胎瘤。肿瘤重1350克。它主要为囊性，有局灶性结节和杂色外观。组织学上，肿瘤为1级不成熟畸胎瘤，以神经胶质成分占主导。在检查的26个切片中均未发现恶性成分。婴儿术中死于与肿瘤大量血供相关的心血管并发症，但肿瘤大体上完全切除。尸检时，在骶骨前方相邻处发现一个小的显微镜下可见的卵黄囊瘤病灶。如果婴儿存活下来，这个病灶很可能是恶性复发的来源。
