Lack E E, Glaun R S, Hefter L G, Seneca R P, Steigman C, Athari F
Department of Pathology, Georgetown University School of Medicine, Washington, DC 20007.
Arch Pathol Lab Med. 1993 Jul;117(7):724-8.
A sacrococcygeal adenocarcinoma is reported in a male patient nearly 40 years old following resection of a histologically mature sacrococcygeal teratoma. The adenocarcinoma arose within soft tissue of the presacral area and residual coccyx and extensively invaded the coccygeal stump that had not been removed in toto with the teratoma during initial surgery at 2 months of age. The patient died nearly 2 years later with local and regional recurrence of tumor and metastases to lymph nodes, liver, lung, bone, and brain. At autopsy there was no evidence of origin from deep internal organs such as the stomach, pancreas, or other sites. Brief comments are made about malignant tumors complicating sacrococcygeal teratomas in both the pediatric age group and adults, and attention is focused on other lesions entering into the differential diagnosis, particularly retrorectal cyst/hamartoma or tailgut cysts. This case underscores an extremely rare but potentially fatal outcome of a patient with sacrococcygeal teratoma.
一名近40岁男性患者，在组织学成熟的骶尾部畸胎瘤切除术后发生了骶尾部腺癌。腺癌起源于骶前区软组织和残留尾骨，广泛侵犯了尾骨残端，该残端在患者2个月大时初次手术切除畸胎瘤时未完全切除。患者在近2年后死亡，肿瘤出现局部和区域复发，并转移至淋巴结、肝脏、肺、骨和脑。尸检未发现肿瘤起源于胃、胰腺或其他深部内脏器官的证据。本文简要讨论了小儿和成人骶尾部畸胎瘤并发恶性肿瘤的情况，并重点关注了需要鉴别的其他病变，特别是直肠后囊肿/错构瘤或尾肠囊肿。该病例强调了骶尾部畸胎瘤患者极为罕见但可能致命的结局。
