Grosfeld J L, Ballantine T V, Lowe D, Baehner R L
Surgery. 1976 Sep;80(3):297-305.
Teratomas were observed in 85 infants and children. Fifty-eight (68%) were girls and 27 (32%) boys. Site of origin was sacrococcygeal in 55 patients (64.8%), mediastinal in ten (11.7%), gonadal in ten (11.7%), presacral in four (4.8%), retroperitoneal in three (3.5%), and cervical in three (3.5%). Sixty-seven (78.8%) teratomas were benign and 18 (21.1%) malignant. Malignant tumors were noted in 11 of 55 sacrococcygeal (20%), two of ten mediastinal (20%), three of eight ovarian (37.5%), and both testicular lesions. Cervical, retroperitoneal, and presacral tumors were benign. Age at diagnosis (greater than 1 month), presence of symptoms (urinary and colonic obstruction), and serum positive for alpha fetoprotein were indicators of malignancy in sacrococcygeal cases. Age was not a factor for teratomas at other sites. Tumor size, presence of calcification, and gross appearance (cystic or solid) did not relate to the tumor's benign or malignant nature. Three of four presacral tumors were associated with anorectal anomalies. Operative resection is the treatment of choice. Four deaths were related to operative hemorrhage. Four of five survivors with malignant teratoma received radiation and chemotherapy. A more aggressive role for combined adjunctive measures is suggested in cases of malignancy.
在85例婴幼儿及儿童中观察到畸胎瘤。58例（68%）为女孩，27例（32%）为男孩。起源部位：55例（64.8%）位于骶尾部，10例（11.7%）位于纵隔，10例（11.7%）位于性腺，4例（4.8%）位于骶前，3例（3.5%）位于腹膜后，3例（3.5%）位于颈部。67例（78.8%）畸胎瘤为良性，18例（21.1%）为恶性。恶性肿瘤见于55例骶尾部畸胎瘤中的11例（20%）、10例纵隔畸胎瘤中的2例（20%）、8例卵巢畸胎瘤中的3例（37.5%）以及2例睾丸畸胎瘤。颈部、腹膜后及骶前肿瘤均为良性。骶尾部畸胎瘤病例中，诊断时年龄大于1个月、存在症状（尿路及结肠梗阻）以及甲胎蛋白血清阳性是恶性的指标。年龄不是其他部位畸胎瘤的相关因素。肿瘤大小、钙化情况及大体外观（囊性或实性）与肿瘤的良恶性无关。4例骶前肿瘤中有3例与肛肠畸形有关。手术切除是首选治疗方法。4例死亡与手术出血有关。5例恶性畸胎瘤幸存者中有4例接受了放疗和化疗。对于恶性病例，建议采取更积极的联合辅助措施。
