1
|
Acharya A, Mahapatra AK, Panigrahi S, Deo RC, Senapati SB. Pulsatile giant sacrococcygeal teratoma appearing like 2nd head. Childs Nerv Syst 2024; 40:1953-1956. [PMID: 38372776 DOI: 10.1007/s00381-024-06324-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
Sacrococcygeal teratoma is a congenital tumor of early infancy. Eighty percent are present in the first month of life. It is considered to be an extragonadal germ cell tumor that can be diagnosed in utero. It is considered to be a rare tumor in infancy and childhood. Incidences in girls are more common as compared to boys. Association with other congenital abnormalities of the gastrointestinal system, cardiovascular system, and urological manifestations may be present. Association with spinal dysraphism may be present. A complete systemic evaluation needs to be done before any surgical intervention. We hereby present you a case of a 5-day-old male child, born from a non-consanguineous marriage, who presented to us with a large swelling at the coccygeal region. The mass had a variegated consistency with an ear-like appendage over it with associated hair, bones, and necrotic tissue in it. The patient was evaluated with imaging (MRI) which revealed a heterogeneously enhancing mass at the sacrococcygeal region with mild extension into the pre-sacral space suggesting sacrococcygeal teratoma. After a complete evaluation for congenital abnormal abnormalities of other sites, gross total excision of the mass was performed. The post-operative condition of the baby was uneventful. A biopsy of the mass revealed a mature cystic teratoma. The baby is under follow-up at present.
Collapse
Affiliation(s)
- Abhijit Acharya
- Dept of Neurosurgery, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India.
| | - A K Mahapatra
- Dept of Neurosurgery, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Souvagya Panigrahi
- Dept of Neurosurgery, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Ram Chandra Deo
- Dept of Neurosurgery, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Satya Bhusan Senapati
- Dept of Neurosurgery, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| |
Collapse
|
2
|
Delio MC, Wang MJ, Young B, Perry J, Hecht JL. Diagnosis and Management of an Enlarging Placental Immature Teratoma: A Case Report. Int J Gynecol Pathol 2024:00004347-990000000-00161. [PMID: 38781130 DOI: 10.1097/pgp.0000000000001036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The clinical imaging and pathology of a rare case of immature teratoma of the placenta is presented with a discussion of controversies related to classification and clinical suggestions for therapy and follow-up.
Collapse
Affiliation(s)
| | | | - Brett Young
- Obstetrics and Gynecology, Beth Israel Deaconess Medical Center at Harvard Medical School, Boston
| | - John Perry
- Department of Pathology, Mount Auburn Hospital, Cambridge, MA
| | | |
Collapse
|
3
|
Konno H, Okpaise OO, Sbragia L, Tonni G, Ruano R. Perinatal Outcomes of Intrauterine Interventions for Fetal Sacrococcygeal Teratoma Based on Different Surgical Techniques-A Systematic Review. J Clin Med 2024; 13:2649. [PMID: 38731178 PMCID: PMC11084939 DOI: 10.3390/jcm13092649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/16/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Background: This study aims to evaluate the outcomes of fetal sacrococcygeal teratoma (SCT) submitted to prenatal interventions. Methods: We performed a systematic literature review of fetal SCT patients and compared the outcomes between open fetal surgery and percutaneous intervention. In addition, we also compared the results of SCT fetuses who did not undergo any surgical intervention (NI). Results: We identified 16 cases of open fetal surgery (OS), 48 cases of percutaneous fetal intervention (PI), and 93 NI patients. The survival rate was 56.2% in OS, 45.8% in PI (p = 0.568), and 71.0% in NI patients. The gestational age at delivery was earlier in cases where there was no survival compared to cases where the fetuses did survive across all evaluated cohorts (OS: p = 0.033, PI: p < 0.001, NI: p < 0.001). The gestational weeks at delivery in OS and PI fetuses were more similar; however, OS tended to be performed later on in pregnancy, and the affected fetuses had more severe presented findings. In our evaluation, we determined that the presence of fetal hydrops and cardiac failure had no significant impact on survival in SCT cases. In NI patients, polyhydramnios was much higher in fetuses who did not survive compared to their surviving cohorts (p < 0.001). Conclusions: In conclusion, gestational age at delivery can affect the short-term prognosis of fetuses affected with sacrococcygeal teratomas. Regardless of the mode of delivery or the necessity for intervention during the fetal period, monitoring for complications, including polyhydramnios, can prevent premature delivery.
Collapse
Affiliation(s)
- Hiroko Konno
- Division of Perinatology, Fetal Diagnosis and Therapy, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-0906, Japan;
| | | | - Lourenço Sbragia
- Division of Pediatric Surgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, SP, Brazil;
| | - Gabriele Tonni
- Prenatal Diagnostic Centre, Department of Obstetrics and Neonatology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Rodrigo Ruano
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Miami, Miami, FL 33136, USA
| |
Collapse
|
4
|
Sabir WN, Ahmed SM, Hasan KM, Mohammed BA, Kareem HO, Najmadden ZB, Abdalla BA, Salih RQ, Mohammed SH, Kakamad FH, Azaldeen HA. Giant sacrococcygeal teratoma in an infant: a case report with a literature review. Ann Med Surg (Lond) 2023; 85:5666-5669. [PMID: 37915688 PMCID: PMC10617840 DOI: 10.1097/ms9.0000000000001274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/26/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance A sacrococcygeal teratoma (SCT) is a rare embryonal tumor that emerges in the sacrococcygeal area. It affects one in every 35 000-40 000 live births. Herein, we report a case of a substantial SCT in a neonate. Case presentation A neonate girl from consanguineous parents was delivered by cesarean section with a large mass (18×17 cm) in the sacrococcygeal area. The baby's birth weight was 5 kg, of which 2.5 belonged to the mass. The vital signs were within normal ranges and she had weak movement with bluish peripheral limbs. Oxygen saturation was around 85% for a short period after birth. According to the American Academy of Pediatric Surgical Section, the tumor was type I. After the fifth day of delivery, a complete resection was done through a chevron incision. The patient was put on 'nil by mouth' for about 24 h and given intravenous fluid. Clinical discussion The histopathological examination of the surgical specimen confirmed extragonadal immature teratoma. The histological classification of SCT is divided into three types: malignant teratomas (consisting of malignant germ cells); immature teratomas (incompletely differentiated structures with a high risk of malignancy or embryonal components); and mature teratomas (fully differentiated tissues). Conclusion SCT has rarely been reported as a giant mass. Radiologic examinations in the early stages of pregnancy may be essential to the early diagnosis of the condition.
Collapse
Affiliation(s)
| | - Sasan M. Ahmed
- Smart Health Tower
- Kscien Organization for Scientific Research (Middle East office)
| | | | | | | | | | - Berun A. Abdalla
- Smart Health Tower
- Kscien Organization for Scientific Research (Middle East office)
| | - Rawezh Q. Salih
- Smart Health Tower
- Kscien Organization for Scientific Research (Middle East office)
| | | | - Fahmi H. Kakamad
- Smart Health Tower
- Kscien Organization for Scientific Research (Middle East office)
- College of Medicine, University of Sulaimani, Sulaimani
| | | |
Collapse
|
5
|
Ma C, Jin Y, Wang Y, Xu H, Zhang J. Beyond liver cancer, more application scenarios for alpha-fetoprotein in clinical practice. Front Oncol 2023; 13:1231420. [PMID: 37781207 PMCID: PMC10540843 DOI: 10.3389/fonc.2023.1231420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Alpha-fetoprotein (AFP) is a commonly used clinical biomarker. Before 1970, the two-way agar diffusion method was mainly used, and the specificity of AFP in the diagnosis of primary liver cancer was satisfactory. However, its positivity rate was not very high. The diagnostic value of AFP is changing with the evolution of detection methods. Here, we performed a literature search to identify English-language publications. The search was performed from January 2015 to April 2023 using the PubMed database and the following terms in [Titles/Abstracts]: alpha-fetoprotein, clinical practice, detection, etc. The references of retrieved articles were also screened to broaden the search. Studies referring to liver cancer and AFP detection methods were excluded. In this review, several clinical application scenarios for AFP were systematically reviewed, and its potential detection value in the future was discussed.
Collapse
Affiliation(s)
- Chenyu Ma
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yuexinzi Jin
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yuhan Wang
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing, China
| | - Huaguo Xu
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jiexin Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| |
Collapse
|
6
|
Baikady SS, Singaram NK. Adult Onset Sacrococcygeal Teratoma. Cureus 2023; 15:e45291. [PMID: 37846273 PMCID: PMC10576869 DOI: 10.7759/cureus.45291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
Sacrococcygeal teratoma (SCT), one of the most common neoplastic tumors in newborns, is found very rarely in adults. These teratomas are germ cell tumours. Most of these tumors are benign and cystic in nature, with only 1-2% of them having a malignant transformation. Most of these tumors are benign and cystic in nature, with only 1-2% of them having malignant transformation. A higher incidence was seen in females. Typically, cystic teratomas are asymptomatic, and so the diagnosis was often made inadvertently during radiographic studies. The majority of treatment is complete surgical excision, and both open and laparoscopic procedures have been proven to be efficient. Histopathologic examination can confirm the diagnosis. We present this unusual instance of a 56-year-old female patient with a sacrococcygeal teratoma.
Collapse
Affiliation(s)
- Shathak S Baikady
- Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupathi, IND
- General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Nagesh K Singaram
- Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, IND
| |
Collapse
|
7
|
Pace E, Johnson TS, Kao SC, Parikh AK, Qi J, Rajderkar DA, Reid JR, Towbin AJ, States LJ. Imaging of pediatric extragonadal pelvic soft tissue tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e29966. [PMID: 36482882 PMCID: PMC10710207 DOI: 10.1002/pbc.29966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/16/2022] [Indexed: 12/13/2022]
Abstract
The most common pediatric extragonadal pelvic cancers include germ cell tumors, sacrococcygeal teratomas, and rhabdomyosarcomas (arising from the urinary bladder, prostate, paratesticular tissues, vagina, uterus, and perineum). This paper describes the radiological and nuclear medicine features of these entities and provides consensus-based recommendations for the assessment at diagnosis, during, and after treatment.
Collapse
Affiliation(s)
- Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, England, United Kingdom
| | - Tatum S. Johnson
- Department of Radiology, Brenner Children’s Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Simon C. Kao
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Ashish K. Parikh
- Department of Radiology, Emory University Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jing Qi
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Dhanashree A. Rajderkar
- Department of Radiology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Janet R. Reid
- Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexander J. Towbin
- Department of Radiology, Cincinnati Children’s Hospital, Cincinnati, Ohio, USA
| | - Lisa J. States
- Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
8
|
Wattamwar GK, Dhok A, Phatak S, Mitra K, Dhawan S, Jadhav SS. An Aberrant Case of Sacrococcygeal Teratoma in a Female Infant Born of Twin Pregnancy. Cureus 2023; 15:e37288. [PMID: 37168169 PMCID: PMC10165938 DOI: 10.7759/cureus.37288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 05/13/2023] Open
Abstract
Sacrococcygeal teratoma (SCT) is an uncommon infantile tumor. It has a female preponderance with malignant variants being more common in males. These usually manifest as palpable masses over the sacral region in infancy which may or may not be associated with neural tube defects. An initial radiological investigation is warranted to analyze the extent and components of the mass to guide an approach for surgical excision. We present a classic case of an SCT in a female infant born as a twin. This mass was evaluated radiologically by X-ray and ultrasound followed by histopathological correlation. This is a case of Altman Type-I lesion and was confirmed as a mature teratoma on histopathological examination.
Collapse
Affiliation(s)
- Gajanan K Wattamwar
- Department of Radiology, NKP (Narendra Kumar Prasadrao) Salve Institute of Medical Sciences, Lata Mangeshkar Hospital, Nagpur, IND
| | - Avinash Dhok
- Department of Radiology, NKP (Narendra Kumar Prasadrao) Salve Institute of Medical Sciences, Lata Mangeshkar Hospital, Nagpur, IND
| | - Suresh Phatak
- Department of Radiology, NKP (Narendra Kumar Prasadrao) Salve Institute of Medical Sciences, Lata Mangeshkar Hospital, Nagpur, IND
| | - Kajal Mitra
- Department of Radiology, NKP (Narendra Kumar Prasadrao) Salve Institute of Medical Sciences, Lata Mangeshkar Hospital, Nagpur, IND
| | - Suruchi Dhawan
- Department of Radiology, NKP (Narendra Kumar Prasadrao) Salve Institute of Medical Sciences, Lata Mangeshkar Hospital, Nagpur, IND
| | - Swaragandha S Jadhav
- Department of Radiology, NKP (Narendra Kumar Prasadrao) Salve Institute of Medical Sciences, Lata Mangeshkar Hospital, Nagpur, IND
| |
Collapse
|
9
|
Mpayo LL, Nkya A, Mawalla S, Manji KP. Post-auricular teratoma in an HIV-exposed newborn. BMJ Case Rep 2023; 16:16/2/e252977. [PMID: 36746517 PMCID: PMC9906262 DOI: 10.1136/bcr-2022-252977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Teratomas in the neonatal age group are mostly benign at first, and the common site is the sacrococcygeal region. They are rarely associated with HIV infection. We report a case of an HIV-exposed newborn with a congenital teratoma at the post-auricular site who developed an infection. Early intervention by total surgical resection will prevent complications such as infections and malignant transformation. A term baby was delivered spontaneously by an HIV-positive mother who was on her regular medications. Prenatal ultrasound carried out in the third trimester showed a cyst swelling on the right post-auricular region. Radiological imaging and the histopathological result revealed a congenital teratoma. A wide major excision with preservation of the facial nerve was performed at the age of 8 weeks. Post-auricular teratomas are the rarest anatomical location and the prevalence of malignant transformation from benign is very low. If left untreated, this tumour is associated with high mortality and malignant transformation rates. An early complete surgical excision allows a good result with a low risk of complications and recurrence.
Collapse
Affiliation(s)
- Lucy Lawrence Mpayo
- Pediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania, United Republic of
| | - Aslam Nkya
- Otorhino-Laryngology, Muhimbili National Hospital, Dar es Salaam, Tanzania, United Republic of
| | - Shabani Mawalla
- Otorhino-Laryngology, Muhimbili National Hospital, Dar-es-Salaam, Tanzania, United Republic of
| | - Karim Premji Manji
- Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| |
Collapse
|
10
|
Mosleh MM, Heo TG, Shin HB, Sohn MJ. Sacrococcygeal teratomas: a case-based review from the perspective of individual multidisciplinary experts. Childs Nerv Syst 2023; 39:57-64. [PMID: 36422695 DOI: 10.1007/s00381-022-05768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Sacrococcygeal teratoma (SCT) is a rare congenital tumor originating from a variant of extragonadal germ cell neoplasm. Herein, we present three cases of neonatal SCTs undergoing surgical resection and reconstruction. We also review the literature to discuss the importance of proper perinatal management and timely surgical intervention depending on the tumor type and maturity to prevent malignant transformation and recurrence and ensure functional outcomes. METHODS AND RESULTS Three cases of SCT were retrospectively analyzed. All infants underwent complete surgical resection of the SCT and coccygectomy during their neonatal/infancy period, followed by pelvic floor and buttock reconstruction while minimizing buttock contour deformity and undesirable skin scar. Two of the cases were histopathologically diagnosed as predominantly cystic mature teratomas of Altman types I and IV, and the third was a mature teratoma of Altman type II. There were no complications or tumor recurrence during the average follow-up period of 5.3 years. CONCLUSIONS This case-based review highlights the role of multidisciplinary team approaches, including prenatal monitoring, oncologic resection, and adequate reconstruction according to the type of tumor and anomaly. Optimal perinatal evaluation allows promising oncologic and functional outcomes in terms of timely intervention to eliminate tumor recurrence and malignant transformation. Complete oncologic surgical resection of SCTs should also include proper functional preservation strategies, such as the reconstruction of the pelvic floor, cosmetic buttock contouring, and preservation of bladder and bowel sphincter function.
Collapse
Affiliation(s)
- Mohammad Mohsen Mosleh
- Department of Neurosurgery and Neuroscience & Radiosurgery Hybrid Research Center, College of Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-Gu, Goyang, Gyeonggi Province, 10380, Korea
| | - Tae Gil Heo
- Department of General Surgery, College of Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-Gu, Goyang, Gyeonggi Province, 10380, Korea
| | - Hyun Beak Shin
- Division of Pediatric Surgery, Department of Surgery, Jeonbuk National University Medical School, 20, Geonjiro, Deokjin-Gu, Jeonju, Jeollabuk-do, 54907, Korea
| | - Moon-Jun Sohn
- Department of Neurosurgery and Neuroscience & Radiosurgery Hybrid Research Center, College of Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-Gu, Goyang, Gyeonggi Province, 10380, Korea.
| |
Collapse
|
11
|
Brown IS, Sokolova A, Rosty C, Graham RP. Cystic lesions of the retrorectal space. Histopathology 2023; 82:232-241. [PMID: 35962741 DOI: 10.1111/his.14769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 12/24/2022]
Abstract
Cysts of the retrorectal space comprise a heterogeneous group of rare lesions. Most develop from embryological remnants and include tailgut cysts, dermoid cysts, rectal duplication cysts, anal canal duplication cysts, sacrococcygeal teratomas and anterior meningocoele. Tailgut cyst is the most common cyst of developmental origin, usually presenting as a multilocular cystic mass with mucoid content and lined by multiple epithelial types. Compared with tailgut cysts, rectal duplication cysts display all layers of the large bowel wall including a well-defined muscularis propria. Retrorectal cysts of non-developmental origin are far less common and represent lesions that either infrequently involve the retrorectal space or undergo extensive cystic change. This review provides an overview of the various histological types of cystic lesions of the retrorectal space, divided into cysts of developmental origin and those of non-developmental origin. A practical pathological and multidisciplinary approach to diagnosing these lesions is presented.
Collapse
Affiliation(s)
- Ian S Brown
- Envoi Specialist Pathologists, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,University of Queensland, Brisbane, Queensland, Australia
| | - Anna Sokolova
- Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia
| | - Christophe Rosty
- Envoi Specialist Pathologists, Brisbane, Queensland, Australia.,University of Queensland, Brisbane, Queensland, Australia
| | | |
Collapse
|
12
|
Leardini D, Cerasi S, Cantarini ME, Facchini E, Prete A, Masetti R. Gluteus as a rare localization of extragonadal teratoma. Pediatr Blood Cancer 2022; 69:e29640. [PMID: 35253332 DOI: 10.1002/pbc.29640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Davide Leardini
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Sara Cerasi
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Elena Cantarini
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elena Facchini
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Arcangelo Prete
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Masetti
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| |
Collapse
|
13
|
Liu JL, Sun PL. Rectal mature teratoma: A case report. World J Clin Cases 2022; 10:7883-7889. [PMID: 36158485 PMCID: PMC9372856 DOI: 10.12998/wjcc.v10.i22.7883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/24/2021] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rectal mature teratoma is rare and has been reported as a case report in this study. Herein, clinical presentation, magnetic resonance imaging findings, and immunohistochemistry showed a pelvic rectal mature teratoma. The case report and the surgical treatment procedure have been discussed below.
CASE SUMMARY A 29-year-old Chinese female showed up with over a 1-mo history of perianal mass that emerged after defecation. Physical examination indicated that the mass was 4 cm × 3 cm × 3 cm. The intraoperative procedure involved ligation of the sigmoid colon 10 cm above the upper edge of the tumor, followed by ligation of the rectum 3.5 cm above the upper edge of the tumor, and subsequent complete removal of the mass. The histopathology confirmed the mature teratoma.
CONCLUSION The tumor can be completely removed using surgery to prevent its recurrence.
Collapse
Affiliation(s)
- Jia-Li Liu
- Department of Anorectal Surgery, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Ping-Liang Sun
- Department of Anorectal Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
14
|
Vereecke E, Herregods N, Morbée L, Laloo F, Chen M, Jans L. Imaging of Structural Abnormalities of the Sacrum: The Old Faithful and Newly Emerging Techniques. Semin Musculoskelet Radiol 2022; 26:469-477. [PMID: 36103888 DOI: 10.1055/s-0042-1754342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The sacrum and sacroiliac joints pose a long-standing challenge for adequate imaging because of their complex anatomical form, oblique orientation, and posterior location in the pelvis, making them subject to superimposition. The sacrum and sacroiliac joints are composed of multiple diverse tissues, further complicating their imaging. Varying imaging techniques are suited to evaluate the sacrum, each with its specific clinical indications, benefits, and drawbacks. New techniques continue to be developed and validated, such as dual-energy computed tomography (CT) and new magnetic resonance imaging (MRI) sequences, for example susceptibility-weighted imaging. Ongoing development of artificial intelligence, such as algorithms allowing reconstruction of MRI-based synthetic CT images, promises even more clinical imaging options.
Collapse
Affiliation(s)
- Elke Vereecke
- Department of Radiology, Ghent University Hospital, Gent, Belgium
| | - Nele Herregods
- Department of Radiology, Ghent University Hospital, Gent, Belgium
| | - Lieve Morbée
- Department of Radiology, Ghent University Hospital, Gent, Belgium
| | - Frederiek Laloo
- Department of Radiology, Ghent University Hospital, Gent, Belgium
| | - Min Chen
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Gent, Belgium
| |
Collapse
|
15
|
Giant malignant sacrococcygeal germ cell tumor in a newborn: A rare case report. Radiol Case Rep 2022; 17:2416-2423. [PMID: 35601377 PMCID: PMC9118099 DOI: 10.1016/j.radcr.2022.03.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Malignant germ cell tumors constitute about 3%-4% of all neoplasms occurring before the age of 15. They arise in the ovaries, the testes, and in several other locations, including the lower back, the chest, the brain, and the abdomen. In infants and young children, the sacrococcygeal region is the most common site for extragonadal germ cell tumors, and teratomas account for the vast majority of sacrococcygeal germ cell tumors. Neonatal sacrococcygeal teratomas are usually benign and rarely they may contain a malignant component that is predominantly a yolk sac tumor. In this article, we describe a rare case of a male newborn with a giant sacrococcygeal mixed germ cell tumor composed of grade 3 immature teratoma and malignant yolk sac elements.
Collapse
|
16
|
Abstract
A newborn girl presenting with respiratory distress soon after birth was found to have a neck mass and required transfer to a paediatric intensive care unit with neonatal expertise. She subsequently underwent endoscopic airway assessment with microlaryngoscopy and bronchoscopy proceeding to open excision of the lesion in the right thyroid lobe on day thirteen of life, resulting in resolution of airway compromise and complete pathological clearance. The baby was discharged 10 days after surgery. Histology confirmed a thyroid teratoma. At 12 months, the child was thriving with no evidence of recurrence. This case illustrates a rare but serious diagnosis that, if not managed in a timely manner, can lead to significant morbidity and mortality.
Collapse
Affiliation(s)
- Joseph Roscamp
- Academic Unit of Medical Education, The University of Sheffield, Sheffield, UK
| | | | - Sanjeev L Gupta
- Ear, Nose and Throat Surgery, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
17
|
Fattahi N, Moeini A, Morani AC, Elsayes KM, Bhosale HR, Badawy M, Menias CO, Rezvani M, Gaballah AH, Shaaban AM. Fat-containing pelvic lesions in females. Abdom Radiol (NY) 2022; 47:362-377. [PMID: 34673996 DOI: 10.1007/s00261-021-03299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022]
Abstract
Pelvic tumors are common in females and have a broad differential diagnosis. The clinical management of pelvic tumors varies widely-from observation to surgical resection-and imaging plays a pivotal role in diagnosis and clinical decision-making in these cases. In particular, imaging can help determine the organ of origin and tissue content of these tumors, which are the most important steps to narrowing the differential diagnosis. Fat has a characteristic appearance and is often easily identified on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). The amount and distribution of intralesional fat varies in different types of tumors. Macroscopic intralesional fat is often easily recognized by its hyperechoic appearance on US and low attenuation on CT similar to subcutaneous fat. On MRI, macroscopic fat is hyperintense on T1-weighted (T1W) images, with characteristic signal loss on fat-saturated sequences and India-ink artifact on opposed-phase T1W images. Macroscopic fat is the hallmark of teratomas, which are the most common ovarian neoplasms. Uterine lipoleiomyomas, peritoneal loose bodies, intraperitoneal and extraperitoneal primary lipomatous tumors such as lipoma and liposarcomas, and extra-adrenal myelolipomas are other pelvic masses distinguished by the presence of macroscopic fat. However, the imaging diagnosis of pelvic masses containing minimal or microscopic fat, such as immature ovarian teratomas, steroid cell ovarian neoplasms, and extramedullary hematopoiesis, can present a diagnostic challenge owing to their nonspecific appearance on US or CT. Obtaining MRI with in-phase and opposed-phase dual-echo T1W sequences and depicting chemical shift artifacts can be helpful in distinguishing these lesions.
Collapse
Affiliation(s)
- Nikoo Fattahi
- Department of Diagnostic and Interventional Imaging, The University of Texas John P. and Katherine G. McGovern Medical School, Houston, TX, USA
| | - Aida Moeini
- Department of Diagnostic Imaging, The University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Ajaykumar C Morani
- Division of Diagnostic Imaging, Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Khaled M Elsayes
- Division of Diagnostic Imaging, Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | | | - Mohamed Badawy
- Division of Diagnostic Imaging, Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | | | - Maryam Rezvani
- Department of Diagnositc Imaging, The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ayman H Gaballah
- Department of Radiology, The University of Missouri Health Care, Columbia, MO, USA
| | - Akram M Shaaban
- Department of Diagnositc Imaging, The University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
18
|
Type- IV sacrococcygeal teratoma presenting as acute urinary retention in a one year old child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.102061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
19
|
Chen I, Wang J, Chien KJ, Lin CC, Chiou YH, Weng KP. Anterior mediastinal tumor found incidentally in a neonate during echocardiography screen. Pediatr Neonatol 2021; 62:441-442. [PMID: 33648896 DOI: 10.1016/j.pedneo.2021.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/18/2020] [Accepted: 01/27/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Iwen Chen
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jenbin Wang
- Department of Pediatric Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kuang-Jen Chien
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chu-Chuan Lin
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yee-Hsuan Chiou
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ken-Pen Weng
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| |
Collapse
|
20
|
Jurcă MC, Ivaşcu ME, Jurcă AA, Kozma K, Magyar I, Şandor MI, Jurcă AD, Zaha DC, Albu CC, Pantiş C, Bembea M, Petcheşi CD. Genetics of congenital solid tumors. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:1039-1049. [PMID: 34171053 PMCID: PMC8343493 DOI: 10.47162/rjme.61.4.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
When we discuss the genetics of tumors, we cannot fail to remember that in the second decade of the twentieth century, more precisely in 1914, Theodore Boveri defined for the first time the chromosomal bases of cancer. In the last 30 years, progresses in genetics have only confirmed Boveri's remarkable predictions made more than 80 years ago. Before the cloning of the retinoblastoma 1 (RB1) gene, the existence of a genetic component in most, if not all, solid childhood tumors were well known. The existence of familial tumor aggregations has been found much more frequently than researchers expected to find at random. Sometimes, the demonstration of this family predisposition was very difficult, because the survival of children diagnosed as having a certain tumor, up to an age at which reproduction and procreation is possible, was very rare. In recent years, advances in the diagnosis and treatment of these diseases have made it possible for these children to survive until the age when they were able to start their own families, including the ability to procreate. Four distinct groups of so-called cancer genes have been identified: oncogenes, which promote tumor cell proliferation; tumor suppressor genes, which inhibit this growth/proliferation; anti-mutational genes, with a role in deoxyribonucleic acid (DNA) stability; and micro-ribonucleic acid (miRNA) genes, with a role in the posttranscriptional process.
Collapse
Affiliation(s)
- Maria Claudia Jurcă
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania; ,
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Sharma R, Khera S, Sinha A, Yadav T. Pure yolk sac tumor of sacrococcygeal region. Autops Case Rep 2021; 11:e2021287. [PMID: 34249791 PMCID: PMC8214897 DOI: 10.4322/acr.2021.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/11/2021] [Indexed: 11/23/2022]
Abstract
The sacrococcygeal region is the most common site for the extragonadal germ cell tumors comprising seminomatous and non-seminomatous tumors. Seminomatous tumors are seminomas, and non-seminomatous tumors comprise mainly teratoma (mature and immature), yolk sac tumor (YST), embryonal carcinoma (EC), and choriocarcinoma. These tumors occur in newborns, infants, and adolescents. Other common sites for extragonadal germ cell tumors are the brain and mediastinum, although they may occur anywhere in the body. These tumors may occur in mixed as well as pure form. So, sectioning from different areas should be done before labeling them as pure germ cell tumors. YST, in its pure form, is rare and therefore should not be missed as it is chemosensitive. The patient should be thoroughly assessed clinically. Imaging also becomes necessary while evaluating swelling in the sacrococcygeal region and can aid in differentials. When the clinical and imaging suspicion of either Sacrococcygeal teratoma or other germ cell tumor is high, serum biomarkers as alfa-fetoprotein should be requested. The serum levels are necessary and should be done preoperatively, postoperatively, and during the course of chemotherapy as follow-up. However, the final diagnosis rests on the histopathological diagnosis. We report one such case of pure YST in the sacrococcygeal region in a 9-month-old female child. The imaging suggested sacrococcygeal teratoma type 4, and high alfa-fetoprotein levels were determined postoperatively.
Collapse
Affiliation(s)
- Rashim Sharma
- All India Institute of Medical Sciences, Department of Pathology and Lab Medicine, Jodhpur, Rajasthan, India
| | - Sudeep Khera
- All India Institute of Medical Sciences, Department of Pathology and Lab Medicine, Jodhpur, Rajasthan, India
| | - Arvind Sinha
- All India Institute of Medical Sciences, Department of Pediatric Surgery, Jodhpur, Rajasthan, India
| | - Taruna Yadav
- All India Institute of Medical Sciences, Diagnostic and Interventional Radiology, Jodhpur, Rajasthan, India
| |
Collapse
|
22
|
Phi JH. Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis. J Korean Neurosurg Soc 2021; 64:406-413. [PMID: 33906346 PMCID: PMC8128526 DOI: 10.3340/jkns.2021.0015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/10/2021] [Indexed: 02/02/2023] Open
Abstract
Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10-15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.
Collapse
Affiliation(s)
- Ji Hoon Phi
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
23
|
A rare presentation of Sacrococcygeal Teratoma as recurrent natal cleft abscess in childhood. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2020.101727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
24
|
Mourad AP, De Robles MS, O'Toole S, Paver E, Winn RD. A case of an asymptomatic sacrococcygeal teratoma diagnosed in adulthood. J Surg Case Rep 2020; 2020:rjaa462. [PMID: 33294159 PMCID: PMC7700776 DOI: 10.1093/jscr/rjaa462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/13/2020] [Indexed: 11/14/2022] Open
Abstract
Sacrococcygeal teratomas are rare congenital tumours that are even more uncommon when present in adulthood. They are derived from residual stem cells in the presacral space that differentiate into clusters of somatic cell. We present the diagnosis, management and post-operative follow-up in a 37-year-old gentleman referred to our department with an incidental finding of a lobulated presacral cystic mass on computed tomography imaging. Magnetic resonance imaging and fluorodeoxyglucose (FDG)-positron emission tomography (PET) scans were performed to further characterize the lesion. The decision was then made for surgical excision and the specimen along with the coccyx was retrieved en-bloc via a trans-sacral surgical approach. Histopathology of the mass uncovered the presence of squamous, respiratory and prostatic epithelium consistent with the diagnosis of a sacrococcygeal teratoma.
Collapse
Affiliation(s)
- Ali P Mourad
- Department of Surgery, The Wollongong Hospital, Wollongong, New South Wales, Australia
| | | | - Sandra O'Toole
- Department of Tissue, Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Elizabeth Paver
- Department of Tissue, Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Robert D Winn
- Department of Surgery, The Wollongong Hospital, Wollongong, New South Wales, Australia
| |
Collapse
|
25
|
Sharma D, Tsibizova VI. Current perspective and scope of fetal therapy: part 1. J Matern Fetal Neonatal Med 2020; 35:3783-3811. [PMID: 33135508 DOI: 10.1080/14767058.2020.1839880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Fetal therapy term has been described for any therapeutic intervention either invasive or noninvasive for the purpose of correcting or treating any fetal malformation or condition. Fetal therapy is a rapidly evolving specialty and has gained pace in last two decades and now fetal intervention is being tried in many malformations with rate of success varying with the type of different fetal conditions. The advances in imaging techniques have allowed fetal medicine persons to make earlier and accurate diagnosis of numerous fetal anomalies. Still many fetal anomalies are managed postnatally because the fetal outcomes have not changed significantly with the use of fetal therapy and this approach avoids unnecessary maternal risk secondary to inutero intervention. The short-term maternal risk associated with fetal surgery includes preterm labor, premature rupture of membranes, uterine wall bleeding, chorioamniotic separation, placental abruption, chorioamnionitis, and anesthesia risk. Whereas, maternal long-term complications include risk of infertility, uterine rupture, and need for cesarean section in future pregnancies. The decision for invasive fetal therapy should be taken after discussion with parents about the various aspects like postnatal fetal outcome without fetal intervention, possible outcome if the fetal intervention is done, available postnatal intervention for the fetal condition, and possible short-term and long-term maternal complications. The center where fetal intervention is done should have facility of multi-disciplinary team to manage both maternal and fetal complications. The major issues in the development of fetal surgery include selection of patient for intervention, crafting effective fetal surgical skills, requirement of regular fetal and uterine monitoring, effective tocolysis, and minimizing fetal and maternal fetal risks. This review will cover the surgical or invasive aspect of fetal therapy with available evidence and will highlight the progress made in the management of fetal malformations in last two decades.
Collapse
Affiliation(s)
- Deepak Sharma
- Department of Neonatology, National Institute of Medical Science, Jaipur, India
| | - Valentina I Tsibizova
- Almazov National Medical Research Centre, Health Ministry of Russian Federation, Saint Petersburg, Russia
| |
Collapse
|
26
|
Ovarian and non-ovarian teratomas: a wide spectrum of features. Jpn J Radiol 2020; 39:143-158. [PMID: 32875471 DOI: 10.1007/s11604-020-01035-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/20/2020] [Indexed: 01/01/2023]
Abstract
Teratoma is a germ cell tumor (GCT) derived from stem cells of the early embryo and the germ line. Teratoma is the most common neoplasm of the ovaries and is usually diagnosed easily using imagings by detecting fat components. However, there are various histopathological types and the imaging findings differ according to the type. Teratoma usually occurs in the gonads or in the midline due to migration of primordial germ cells during development. The clinical course of teratomas depends on the age of the patient, histological type, and anatomical site. Sometimes teratomas show unusual manifestations, such as mature teratoma without demonstrable fat components, torsion, rupture, growing teratoma syndrome, anti-N-methyl-D-aspartate receptor encephalitis, and autoimmune hemolytic anemia. For all of these reasons, teratomas demonstrate a wide spectrum of imaging features and radiologists should be familiar with these variabilities. The present article aims to introduce a model encompassing types of GCTs based on their developmental potential, and to review several histopathological types in various anatomical sites and unusual manifestations of teratomas, with representative imaging findings.
Collapse
|
27
|
Hanafy AK, Mujtaba B, Yedururi S, Jensen CT, Sanchez R, Austin MT, Morani AC. Imaging in pediatric ovarian tumors. Abdom Radiol (NY) 2020; 45:520-536. [PMID: 31745573 DOI: 10.1007/s00261-019-02316-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The spectrum of ovarian tumors in the pediatric population differs significantly from that in adults. Germ cell tumors are the predominant class of ovarian tumors in children, whereas epithelial tumors are the most common in adults. Ultrasonography is the modality of choice for the initial evaluation of pediatric ovarian tumors. Determining the diagnosis based on imaging may prove difficult, and combining the imaging findings with the clinical scenario is very helpful in reaching a differential diagnosis during clinical practice. We will discuss the spectrum of ovarian neoplasms in the pediatric population and describe their clinical, pathologic, and imaging characteristics. A few unique entities related to ovarian tumors, such as growing teratoma syndrome, anti-N-methyl-D-aspartate receptor encephalitis, and hereditary ovarian tumor syndromes, are also discussed. In addition, we will review several entities that may mimic ovarian neoplasms as well as their distinct imaging features.
Collapse
Affiliation(s)
- Abdelrahman K Hanafy
- Diagnostic Radiology, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, 78229, USA
| | - Bilal Mujtaba
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Sireesha Yedururi
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Corey T Jensen
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Ramon Sanchez
- Radiology, Children's National Health System, 111 Michigan Avenue NW, Washington, DC, 20010, USA
| | - Mary T Austin
- Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Ajaykumar C Morani
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA.
| |
Collapse
|
28
|
Mohamed IA, El-Badri N, Zaher A. Wnt Signaling: The double-edged sword diminishing the potential of stem cell therapy in congenital heart disease. Life Sci 2019; 239:116937. [PMID: 31629761 DOI: 10.1016/j.lfs.2019.116937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/26/2019] [Accepted: 10/04/2019] [Indexed: 12/26/2022]
Abstract
Stem cell therapy using bone marrow derived or mesenchymal stem cells has become a popular option for cardiovascular disease treatment, however the administration of embryonic stem cells has been mostly experimental. Remarkably, most of these ongoing clinical trials involve adult patients, but little is known regarding the safety and efficacy of stem cell therapy in newborns and children battling congenital heart diseases. Furthermore, cell delivery methods involve the administration of stem cells without pre-differentiation, and without consideration for the consequent process of cardiac development. Interestingly, in-vitro studies have demonstrated that the differentiation of embryonic stem cells into cardiomyocytes imitates the stages of cardiogenesis. Wnt signaling plays a profound role during the earliest stages of cardiogenesis and cardiac differentiation. In fact inappropriate Wnt signaling is associated with numerous cardiac disorders especially congenital heart disease. Furthermore, cell-extracellular matrix interactions were shown to be critical for stem cell differentiation and adequate cardiogenesis. Since extracellular matrix molecules are fundamental for maintenance and repair during heart disease and congenital heart disease, they may offer a novel approach for therapy. Herein we aim to review the critical role of Wnt signaling, as well as the profound importance of cell extracellular matrix interaction, during cardiogenesis. Both of these processes are crucial for precise stem cell differentiation into cardiomyocytes and developing efficacious regenerative therapy for congenital heart disease.
Collapse
Affiliation(s)
- Iman A Mohamed
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, 6th of October City, 12588, Egypt
| | - Nagwa El-Badri
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, 6th of October City, 12588, Egypt
| | - Amr Zaher
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, 6th of October City, 12588, Egypt; National Heart Institute, Giza, Egypt.
| |
Collapse
|
29
|
[Imaging of abdominal tumors in childhood and adolescence : Part II: relevant intra-abdominal and retroperitoneal tumor entities]. Radiologe 2019; 58:673-686. [PMID: 29947934 DOI: 10.1007/s00117-018-0410-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abdominal and pelvic tumors in children and adolescents can be manifested intra-abdominally and also often in the retroperitoneum. The most important pediatric primary retroperitoneal space-occupying lesions are nephroblastoma (Wilms' tumor) and neuroblastoma, whereby imaging plays a decisive role in the diagnostics and differentiation of the two entities. Benign tumors of the mesentery and gastrointestinal tract occur more frequently in children than malignant lesions. The benign entities include lipoma, polyps and vascular tumors, such as lymphatic malformations. Of the malignant sarcomas, abdominal rhabdomyosarcomas (RMS) occur relatively often in childhood and adolescence. The most frequent pediatric abdominal lymphoma is Burkitt's lymphoma, an aggressive subtype of non-Hodgkin's lymphoma. Relevant tumor entities in childhood are also germ cell tumors, which originate from the genitals (gonadal) or can be extragonadally manifested. The benignancy or malignancy of germ cell tumors ranges from benign teratomas to highly malignant entities, such as yolk sac tumors. The germ cell tumors, just as all pediatric abdominal mass lesions, show a broad spectrum of tumor aggressiveness, malignancy and therefore also prognosis and mortality for the affected children and adolescents.
Collapse
|
30
|
Chaturvedi A, Franco A, Chaturvedi A, Klionsky NB. Caudal cell mass developmental aberrations: an imaging approach. Clin Imaging 2018; 52:216-225. [PMID: 30138861 DOI: 10.1016/j.clinimag.2018.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 11/30/2022]
Abstract
The objective of this review is to describe antenatal and postnatal imaging criteria, which allow diagnosis and aid workup, prognostication and treatment of developmental anomalies of the caudal cell mass. The lower spinal cord (conus medullaris), filum terminale and inferior lumbar and sacral nerve roots develop from the caudal cell mass, a remnant of the embryologic primitive streak composed of undifferentiated pluripotential cells. Anomalous caudal cell mass development can manifest as tight filum terminale, caudal dysgenesis, terminal myelocystocele, anterior sacral meningocele or sacrococcygeal teratoma. Lower spinal cord development occurs simultaneously and in topological proximity to the developing lower gastrointestinal and genitourinary tracts, leading to coexistent malformations. We review the embryology of the caudal cell mass, describe the role of antenatal and postnatal imaging for diagnosing, staging, prognosticating and guiding intranatal or postnatal intervention for developmental anomalies of this region and briefly discuss clinical manifestations and treatment goals and strategies. An overview of antenatal imaging diagnosis of associated multisystem abnormalities will be provided where applicable.
Collapse
Affiliation(s)
| | - Arie Franco
- University of Rochester Medical Center, Rochester, NY, USA
| | | | | |
Collapse
|
31
|
Sacrococcygeal Teratoma Presenting with Vaginal Discharge and Polyp in an Infant. J Pediatr Adolesc Gynecol 2018; 31:318-320. [PMID: 29269272 DOI: 10.1016/j.jpag.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/29/2017] [Accepted: 12/09/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Sacrococcygeal teratoma accounts for the most common solid tumor in neonates. Because of improved technology, 50%-70% of cases can be diagnosed antenatally during routine ultrasound screenings. If not diagnosed antenatally, clinical findings at birth are distinct in most cases including a palpable or visible mass. CASE We report an unusual case of a 1-year-old girl who presented with persistent vaginal discharge leading to diagnosis of a mucosal polypoid lesion of the vagina, ultimately revealing a hidden sacrococcygeal teratoma. SUMMARY AND CONCLUSION We suggest thorough investigation of all infants who present with purulent discharge and recurrent vaginal mass; sacrococcygeal teratoma should routinely be considered as a differential diagnosis.
Collapse
|