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Rulli SB, Ahtiainen P, Ratner LD, Jonas K, Calandra RS, Poutanen M, Huhtaniemi I. Elevated chorionic gonadotropic hormone in transgenic mice induces parthenogenetic activation and ovarian teratomas. Mol Cell Endocrinol 2024; 587:112214. [PMID: 38537882 DOI: 10.1016/j.mce.2024.112214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/25/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
Both male and female reproductive functions are impacted by altered gonadotrophin secretion and action, which may also influence the development of endocrine tumours. To ascertain if chronic hypersecretion of human chorionic gonadotropin (hCG) contributes to the development of gonadal tumours, double transgenic (TG) mice that overexpress hCGα- and β-subunits were analysed. By the age of two months, ovarian tumours with characteristics of teratomas developed with 100% penetrance. Teratomas were also seen in wild-type ovaries orthotopically transplanted into TG mice, demonstrating an endocrine/paracrine mechanism for the hCG-induced ovarian tumorigenesis. Both in vitro and in vivo experiments showed oocyte parthenogenetic activation in TG females. In addition, ovaries showed reduced ovulatory gene expression, inhibited ERK1/2 phosphorylation, and impaired cumulus cell expansion. Hence, persistently high endocrine hCG activity causes parthenogenetic activation and development of ovarian teratomas, along with altered follicle development and impaired ERK1/2 signalling, offering a novel mechanism associated with the molecular pathogenesis of ovarian teratomas.
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Affiliation(s)
- Susana B Rulli
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Kiinamyllynkatu 10, FIN-20520, Turku, Finland; Instituto de Biología y Medicina Experimental-CONICET, Vuelta de Obligado 2490, 1428, Buenos Aires, Argentina; Centro de Estudios Biomédicos Básicos, Aplicados y Desarrollo (CEBBAD), Universidad Maimónides, Hidalgo 775, C1405BCK, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Petteri Ahtiainen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Kiinamyllynkatu 10, FIN-20520, Turku, Finland
| | - Laura D Ratner
- Instituto de Biología y Medicina Experimental-CONICET, Vuelta de Obligado 2490, 1428, Buenos Aires, Argentina
| | - Kim Jonas
- Department of Digestion, Metabolism and Reproduction, Institute of Reproductive and Developmental Biology, Hammersmith Campus, Imperial College London, London, W12 0NN, UK; Department of Women and Children's Health, School of Population and Life Course Sciences, King's College London, London, SE1 1UL, UK
| | - Ricardo S Calandra
- Instituto de Biología y Medicina Experimental-CONICET, Vuelta de Obligado 2490, 1428, Buenos Aires, Argentina
| | - Matti Poutanen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Kiinamyllynkatu 10, FIN-20520, Turku, Finland; Turku Center for Disease Modeling, University of Turku, Kiinamyllynkatu 10, FIN-20520, Turku, Finland
| | - Ilpo Huhtaniemi
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Kiinamyllynkatu 10, FIN-20520, Turku, Finland; Department of Digestion, Metabolism and Reproduction, Institute of Reproductive and Developmental Biology, Hammersmith Campus, Imperial College London, London, W12 0NN, UK
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2
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Jane Chua K, Barr A, Prints M, Ruskin R, Brooks R. Management of ruptured ovarian teratoma mimicking advanced ovarian cancer. Gynecol Oncol Rep 2024; 53:101386. [PMID: 38596159 PMCID: PMC11001759 DOI: 10.1016/j.gore.2024.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024] Open
Abstract
•Chronic chemical peritonitis caused by spontaneous rupture of a mature cystic teratoma may result in prolonged hospitalization and respiratory decline and can mimic a gynecologic malignancy.•Earlier surgical intervention for mature teratoma may prevent morbidity.•Inclusion of a gynecologic oncologist is advised for management discussions and/or surgical back-up.•Complex benign gynecologic surgeries may have some benefit for gynecologic oncologic trainees, which can be used for later oncologic cases.
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Affiliation(s)
- Katherine Jane Chua
- University of California, Davis Medical Center, Department of Gynecology Oncology, USA
| | - Alice Barr
- University of California, Davis Medical Center, Department of Gynecology Oncology, USA
| | - Miranda Prints
- University of California, San Francisco Fresno, Department of Obstetrics and Gynecology, USA
| | - Rachel Ruskin
- University of California, Davis Medical Center, Department of Gynecology Oncology, USA
| | - Rebecca Brooks
- University of California, Davis Medical Center, Department of Gynecology Oncology, USA
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Bührer E, D'Haese D, Daugaard G, de Wit R, Albany C, Tryakin A, Fizazi K, Stahl O, Gietema JA, De Giorgi U, Cafferty FH, Hansen AR, Tandstad T, Huddart RA, Necchi A, Sweeney CJ, Garcia-Del-Muro X, Heng DYC, Lorch A, Chovanec M, Winquist E, Grimison P, Feldman DR, Terbuch A, Hentrich M, Bokemeyer C, Negaard H, Fankhauser C, Shamash J, Vaughn DJ, Sternberg CN, Heidenreich A, Collette L, Gillessen S, Beyer J. Impact of teratoma on survival probabilities of patients with metastatic non-seminomatous germ cell cancer: Results from the IGCCCG Update Consortium. Eur J Cancer 2024; 202:114042. [PMID: 38564927 DOI: 10.1016/j.ejca.2024.114042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
AIMS To resolve the ongoing controversy surrounding the impact of teratoma (TER) in the primary among patients with metastatic testicular non-seminomatous germ-cell tumours (NSGCT). PATIENTS AND METHODS Using the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium database, we compared the survival probabilities of patients with metastatic testicular GCT with TER (TER) or without TER (NTER) in their primaries corrected for known prognostic factors. Progression-free survival (5y-PFS) and overall survival at 5 years (5y-OS) were estimated by the Kaplan-Meier method. RESULTS Among 6792 patients with metastatic testicular NSGCT, 3224 (47%) had TER in their primary, and 3568 (53%) did not. In the IGCCCG good prognosis group, the 5y-PFS was 87.8% in TER versus 92.0% in NTER patients (p = 0.0001), the respective 5y-OS were 94.5% versus 96.5% (p = 0.0032). The corresponding figures in the intermediate prognosis group were 5y-PFS 76.9% versus 81.6% (p = 0.0432) in TER and NTER and 5y-OS 90.4% versus 90.9% (p = 0.8514), respectively. In the poor prognosis group, there was no difference, neither in 5y-PFS [54.3% in TER patients versus 55.4% (p = 0.7472) in NTER], nor in 5y-OS [69.4% versus 67.7% (p = 0.3841)]. NSGCT patients with TER had more residual masses (65.3% versus 51.7%, p < 0.0001), and therefore received post-chemotherapy surgery more frequently than NTER patients (46.8% versus 32.0%, p < 0.0001). CONCLUSION Teratoma in the primary tumour of patients with metastatic NSGCT negatively impacts on survival in the good and intermediate, but not in the poor IGCCCG prognostic groups.
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Affiliation(s)
- Emanuel Bührer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - David D'Haese
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Gedske Daugaard
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ronald de Wit
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Costantine Albany
- Horizon Oncology Research, 1345 Unity PI Ste 345, Lafayette, IN, United States of America
| | - Alexey Tryakin
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Olof Stahl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | | | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Italy and the Italian Germ Cell Cancer Group (IGG), Italy
| | - Fay H Cafferty
- Medical Research Council Clinical Trials Unit, University College London (UCL), London, United Kingdom; Institute of Cancer Research Clinical Trials and Statistics Unit, Sutton, United Kingdom
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Torgrim Tandstad
- The Cancer Clinic, St Olavs University Hospital and Department of Clinical and Molecular Medicine, The Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Andrea Necchi
- Vita-Salute San Raffaele University, Milan, Italy; Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Christopher J Sweeney
- South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, Australia
| | - Xavier Garcia-Del-Muro
- Catalan Institute of Oncology, IDIBELL Institute of Research, University of Barcelona, Barcelona, Spain
| | - Daniel Y C Heng
- Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Anja Lorch
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland; Department of Urology, University Hospital Dusseldorf, Dusseldorf, Germany
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia; Cancer Research Institute, Biomedical Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Eric Winquist
- Division of Medical Oncology, Western University and London Health Sciences Centre, London, Ontario, Canada
| | - Peter Grimison
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, Australia
| | - Darren R Feldman
- Memorial Sloan Kettering Cancer Centre, New York, NY, United States of America; Weill Medical College of Cornell University, New York, NY, United States of America
| | - Angelika Terbuch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Marcus Hentrich
- Department of Hematology and Oncology, Red Cross Hospital, University of Munich, Munich, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and BMT with Section Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Helene Negaard
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | | | - David J Vaughn
- University of Pennsylvania, Philadelphia, PA, United States of America
| | | | - Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Austria
| | - Laurence Collette
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland (IOSI), EOC, Bellinzona, Switzerland; Universita della Svizzera Italiana (USI), Lugano, Switzerland
| | - Jörg Beyer
- University Department of Medical Oncology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
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Pan ZK, Wu MH, Ye JS. Retrorectal teratoma: A case insight on treatment and outcomes. Asian J Surg 2024:S1015-9584(24)00730-9. [PMID: 38653694 DOI: 10.1016/j.asjsur.2024.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Zhen-Kun Pan
- Department of General Surgery, Beijing Yanqing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Meng-Hua Wu
- Department of Urology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jin-Sheng Ye
- Department of General Surgery/Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
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Ortega-Ruiz OR, Acevedo-Castillo CD, Pérez-Ruano LA, Caro-Osorio E. Simultaneous spine extradural and intradural teratomas in a pediatric patient: A rare presentation with insights in the flawed migration of germ cells theory. Childs Nerv Syst 2024; 40:1011-1017. [PMID: 38429504 DOI: 10.1007/s00381-024-06317-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/08/2024] [Indexed: 03/03/2024]
Abstract
Spinal teratomas are infrequent lesions in the pediatric population. These lesions can be extradural, intradural or intramedullary. We present a case of an 8-month-old boy that was assessed for underdevelopment of motor milestones. The neurologic examination revealed hyporeflexia, decreased sensation and flaccid paraplegia. MRI of the spine revealed two simultaneous and independent lesions in the extradural and intradural compartment. A laminectomy was performed for the T4-T7 vertebrae with total resection of both lesions. The histopathological analysis confirmed both lesions to be mature cystic teratomas. At the 1-year follow-up, the patient remained with no recovery of neurological function. A debate takes place regarding the etiology of formation of these lesions in the spine. The simultaneous presentation of two independent lesions in this patient could contribute to define the flawed migration of germ cells theory as the etiology for formation of teratomatous lesions in the spine.
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Affiliation(s)
- Omar R Ortega-Ruiz
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, Av. Batallon de San Patricio 112, Real San Agustín, 66,260 San Pedro Garza García, Nuevo León, Mexico
| | - Carlos D Acevedo-Castillo
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, Av. Batallon de San Patricio 112, Real San Agustín, 66,260 San Pedro Garza García, Nuevo León, Mexico
| | - Luis Alejandro Pérez-Ruano
- Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, Av. Batallon de San Patricio 112, Real San Agustín, 66,260 San Pedro Garza García, Nuevo León, Mexico
| | - Enrique Caro-Osorio
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
- Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, Av. Batallon de San Patricio 112, Real San Agustín, 66,260 San Pedro Garza García, Nuevo León, Mexico.
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6
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Sahai A, Narkhede K, Shriwastav P, Gaikwad A, Marfatia H. Mature Cystic Oral Teratoma in a Neonate- A Case Report. Indian J Otolaryngol Head Neck Surg 2024; 76:1994-1997. [PMID: 38566646 PMCID: PMC10982191 DOI: 10.1007/s12070-023-04336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/01/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Neonatal oral cavity masses present complex diagnostic and management challenges, often involving respiratory distress. We present a case of a 1-day-old male neonate with an oral cavity mass and respiratory distress, whose antenatal scan revealed polyhydramnios and a nasopalatine cyst. CASE REPORT Clinical examination revealed a 5 * 5 cm cystic swelling arising from the right hard palate. CT scans confirmed an intraoral cystic lesion with a complete cleft palate and excluded oropharyngeal/neck extension. Aspiration of cystic fluid facilitated surgical excision, leading to a histopathological diagnosis of mature cystic teratoma. Primary closure of the soft palate defect was performed. Histopathological examination revealed it to be mature cystic teratoma. CONCLUSION This case underscores the intricate interplay between antenatal imaging, clinical assessment, and surgical intervention in managing neonatal oral cavity masses. The successful excision and histopathological confirmation of a mature cystic teratoma highlights the significance of accurate diagnosis and timely intervention. The complexities surrounding neonatal oral cavity masses necessitate a comprehensive approach to optimize patient outcomes.
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Affiliation(s)
- Anoushka Sahai
- Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
| | - Kartik Narkhede
- Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
| | - Pooja Shriwastav
- Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
| | - Ashwinikumar Gaikwad
- Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
| | - Hetal Marfatia
- Department of ENT and Head-Neck Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, India
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Atsukawa N, Nakai G, Omura S, Yamamoto K, Yamada T, Ohmichi M, Osuga K. Imaging features of mucinous carcinoma arising from mature teratoma showing cytokeratin 7+ and cytokeratin 20+ expression profile: A case report. Radiol Case Rep 2024; 19:1288-1293. [PMID: 38292777 PMCID: PMC10825558 DOI: 10.1016/j.radcr.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/01/2024] [Indexed: 02/01/2024] Open
Abstract
Ovarian mature teratomas are benign, but malignant transformation can occur infrequently, especially in women of advanced age. The tissue that undergoes malignant change is mostly squamous cell carcinoma, although adenocarcinoma has been reported in a small number of cases. The immunostaining results of adenocarcinoma usually show a cytokeratin (CK)7-/CK20+ expression profile, corresponding to lower gastrointestinal tract origin. In this report, we describe a case of mucinous carcinoma arising from an ovarian mature teratoma showing a CK7+/CK20+ profile and discuss its imaging features. A 40-year-old woman presented to her primary care physician with abdominal distension and poor oral intake, and she was referred to our hospital. She had been diagnosed with an ovarian mature teratoma at our institution 3 years earlier. At the current presentation, pelvic magnetic resonance imaging showed a large multilocular cystic mass with adipose tissue extending into the upper abdomen. Densely packed cysts were observed inside the mass, which showed weak contrast enhancement on contrast-enhanced imaging and a mildly high signal on diffusion-weighted imaging. A portion of the cysts also showed abnormal 18F-fluorodeoxyglucose uptake (maximum standardized uptake value, 13.2) on positron emission tomography/computed tomography. The patient was subsequently diagnosed with mucinous carcinoma showing a CK7+/CK20+ profile arising from a mature teratoma by pathologic examination. This mucinous carcinoma arising from a mature teratoma showed a CK7+/CK20+ profile and took the form of densely packed multilocular cysts. In this respect, it was similar to primary ovarian epithelial mucinous carcinoma on both magnetic resonance imaging and pathologic examination despite showing a much higher maximum standardized uptake value than that of primary ovarian mucinous carcinoma. When a large ovarian teratoma contains a large multilocular cyst, the presence of densely packed multilocular cysts should not be missed even in a mass without solid components. Clinicians should consider the possibility of mucinous carcinoma showing a CK7+/CK20+ profile arising from a mature teratoma in such cases.
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Affiliation(s)
- Natsuko Atsukawa
- Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Go Nakai
- Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Shoko Omura
- Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Kazuhiro Yamamoto
- Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Takashi Yamada
- Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Masahide Ohmichi
- Department of Obstetrics and Gynaecology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Keigo Osuga
- Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
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Sharma J, Yadav U, Tej V, Malik R, Sarawagi R, Rahman N, Kumar A, Patel A, Bhagat AC. Infantile fetiform abdominal mass: Teratoma or fetus in fetu? A case report with insights into radiological diagnosis and surgical management. Radiol Case Rep 2024; 19:1304-1308. [PMID: 38292806 PMCID: PMC10825550 DOI: 10.1016/j.radcr.2023.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024] Open
Abstract
Fetus-in-fetu (FIF) is a rare congenital anomaly in which a malformed parasitic twin develops within the body of a live fetus or child. Abdominal teratoma, a type of germ cell tumor, can be a great imaging mimicker of FIF and vice-versa, as they both can present as a heterogeneous mass with calcifications and a fat component. Radiological differentiation of these 2 entities should be made because of the difference in surgical planning and treatment options. Features such as visualization of distinct bony vertebral elements and encysted cystic components are the specific features of Fetus in fetu [1]. In contrast, the presence of elevated serum markers can help diagnose teratoma. Here, we report a case of a 5-month-old girl presented with progressive distension of the upper abdomen for the last 2 months, noticed by her mother. Her initial imaging with abdominal X-ray and ultrasonography showed the presence of a large heterogenous solid-cystic mass in the upper abdomen with large elongated calcifications. A provisional diagnosis of teratoma vs FIF was considered. CECT abdomen showed clear identification of osseous structures of the axial and appendicular skeleton within a fat density mass, along with an encapsulated cystic component, strongly suggestive of FIF. Her serum tumor markers were within normal limits. The final diagnosis of FIF was confirmed on Laparotomy and postoperative specimens.
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Affiliation(s)
- Jitendra Sharma
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Upasna Yadav
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Varun Tej
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Rajesh Malik
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Radha Sarawagi
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Nadeem Rahman
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Aman Kumar
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Ankur Patel
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Abhinav C. Bhagat
- Department of Radiodiagnosis, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
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Singh S, Saini P, Mandal S, Mallya V, Gopal A. Immature Teratoma of Ethmoid Sinus Masquerading as Antrochoanal Polyp: A Rare Case Report with Literature Review. Indian J Otolaryngol Head Neck Surg 2024; 76:2048-2050. [PMID: 38566672 PMCID: PMC10982141 DOI: 10.1007/s12070-023-04395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
Teratomas are rare neoplasms that arise from totipotent stem cells. Teratomas of the head and neck are extremely rare, constituting about 10% of all cases and usually present in the neonatal period. Extensive literature search has shown that there are only two cases reportedof teratoma of the ethmoid sinus; one as a mature teratoma in a neonate and another was histologically immature teratoma in an adult male (Mwang'ombe et al. in East Afr Med J 79(2):106-107, 2002; Aggarwal et al. in J Postgrad Med 59(2):138-141, 2013). We hereby report the second case of immature teratoma of ethmoid sinus origin in an adult male.
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Affiliation(s)
- Shabnam Singh
- Department of Pathology, Maulana Azad Medical College and Associated Hospitals, 642- Pocket E, Mayur Vihar Phase II, New Delhi, 110002 India
| | - Pooja Saini
- Department of Pathology, Maulana Azad Medical College and Associated Hospitals, 642- Pocket E, Mayur Vihar Phase II, New Delhi, 110002 India
| | - Shramana Mandal
- Department of Pathology, Maulana Azad Medical College and Associated Hospitals, 642- Pocket E, Mayur Vihar Phase II, New Delhi, 110002 India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College and Associated Hospitals, 642- Pocket E, Mayur Vihar Phase II, New Delhi, 110002 India
| | - Ashish Gopal
- Department of ENT, Maulana Azad Medical College and Associated Hospitals, New Delhi, 110002 India
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10
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Pongratanakul P, Bremmer F, Pauls S, Poschmann G, Kresbach C, Parmaksiz F, Skowron MA, Fuß J, Stephan A, Paffenholz P, Stühler K, Schüller U, Ströbel P, Heidenreich A, Che Y, Albers P, Nettersheim D. Assessing the risk to develop a growing teratoma syndrome based on molecular and epigenetic subtyping as well as novel secreted biomarkers. Cancer Lett 2024; 585:216673. [PMID: 38296184 DOI: 10.1016/j.canlet.2024.216673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/05/2024]
Abstract
In germ cell tumors (GCT), a growing teratoma during chemotherapy with decreasing tumor markers was defined as 'growing teratoma syndrome' (GTS) by Logothetis et al. in 1982. So far, its pathogenesis and specific treatment options remain elusive. We aimed at updating the GTS definition based on molecular and epigenetic features as well as identifying circulating biomarkers. We selected 50 GTS patients for clinical characterization and subsequently 12 samples were molecularly analyzed. We further included 7 longitudinal samples of 2 GTS patients. Teratomas (TER) showing no features of GTS served as controls. GTS were stratified based on growth rates into a slow (<0.5 cm/month), medium (0.5-1.5) and rapid (>1.5) group. By analyzing DNA methylation, microRNA expression and the secretome, we identified putative epigenetic and secreted biomarkers for the GTS subgroups. We found that proteins enriched in the GTS groups compared to TER were involved in proliferation, DNA replication and the cell cycle, while proteins interacting with the immune system were depleted. Additionally, GTSrapid seem to interact more strongly with the surrounding microenvironment than GTSslow. Expression of pluripotency- and yolk-sac tumor-associated genes in GTS and formation of a yolk-sac tumor or somatic-type malignancy in the longitudinal GTS samples, pointed at an additional occult non-seminomatous component after chemotherapy. Thus, updating the Logothetis GTS definition is necessary, which we propose as follows: The GTS describes a continuously growing teratoma that might harbor occult non-seminomatous components considerably reduced during therapy but outgrowing over time again.
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Affiliation(s)
- Pailin Pongratanakul
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Bremmer
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Stella Pauls
- Molecular Proteomics Laboratory (MPL), Biological and Medical Research Center (BMFZ), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Gereon Poschmann
- Molecular Proteomics Laboratory (MPL), Biological and Medical Research Center (BMFZ), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Catena Kresbach
- Institute of Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Fatma Parmaksiz
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Margaretha A Skowron
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Janina Fuß
- Competence Centre for Genomic Analysis, Kiel, Germany
| | - Alexa Stephan
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Pia Paffenholz
- Department of Urology, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kai Stühler
- Molecular Proteomics Laboratory (MPL), Biological and Medical Research Center (BMFZ), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ulrich Schüller
- Institute of Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp Ströbel
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Axel Heidenreich
- Department of Urology, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Yue Che
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Peter Albers
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Daniel Nettersheim
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Lighthouse Project Germ Cell Tumors, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.
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Nery B, Durand VR, Rabello RDA, De Oliveira ACM, Quaggio E, Ortega MM, Camporezi B, Segundo JADS. Occipital dermal sinus associated with infectious teratoma in an adult patient affected by Klippel-Feil syndrome: Rare case report and literature review. Surg Neurol Int 2024; 15:94. [PMID: 38628535 PMCID: PMC11021108 DOI: 10.25259/sni_1024_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/11/2024] [Indexed: 04/19/2024] Open
Abstract
Background The Klippel-Feil syndrome (KFS) is a rare congenital anomaly characterized by the fusion of cervical vertebrae, which may be associated with other malformations, such as dermoid tumors and teratoma. Some theories explain the embryology of these associations. Another condition that may be present is the dermal sinus (DS), communication between intracranial tumors and the subcutaneous tissue, and predisposing infections. This case report aims to describe an association between these three pathologies as well as correlate them from the literature. This report was based on medical records retrospectively reviewed associated with the systematic bibliographical consultation using indexed databases based on inclusion and exclusion methods. Case Description An adult male patient, 24 years old, was admitted to our service, presenting fever and meningeal irritation as initial symptoms. In the patient's clinical history, he was diagnosed with an occipital DS in his childhood, which was previously instructed to be operated on by another neurosurgical team, but the patient chose not to perform the procedure. The magnetic resonance imaging investigation showed a DS associated with a cerebellar infected mass with 2 cm on its main diameter. The patient was treated with preoperative antibiotic therapy and underwent gross total surgical resection of the tumor as well as DS correction, confirmed in the histopathological examination as a teratoma. After surgery, further computed tomography scan analysis showed the presence of cervical vertebrae fusion, compatible with KFS diagnosis. Conclusion The association between KFS, cerebellar teratoma, and DS has not yet been described in the literature, with only the association of the first two being extremely rare.
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Le PH, Tsou YK, Wu RC. A Hairy Pedunculated Polypoid Lesion of Sigmoid Colon in a Female with Abdominal Pain and Diarrhea. Gastrointest Endosc 2024:S0016-5107(24)00167-6. [PMID: 38492816 DOI: 10.1016/j.gie.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/25/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Puo-Hsien Le
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Taiwan Association of the Study of Small Intestinal Disease, Taoyuan, Taiwan.
| | - Yung-Kuan Tsou
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ren-Chin Wu
- Department of Anatomic Pathology, Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
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13
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Liu S, Wang X, Liu X, Li S, Liao H, Qiu X. Non-invasive differential diagnosis of teratomas from other intracranial germ cell tumours using MRI-based fractal and radiomic analyses. Eur Radiol 2024; 34:1434-1443. [PMID: 37672052 DOI: 10.1007/s00330-023-10177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/07/2023] [Accepted: 07/20/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES The histologic subtype of intracranial germ cell tumours (IGCTs) is an important factor in deciding the treatment strategy, especially for teratomas. In this study, we aimed to non-invasively diagnose teratomas based on fractal and radiomic features. MATERIALS AND METHODS This retrospective study included 330 IGCT patients, including a discovery set (n = 296) and an independent validation set (n = 34). Fractal and radiomic features were extracted from T1-weighted, T2-weighted, and post-contrast T1-weighted images. Five classifiers, including logistic regression, random forests, support vector machines, K-nearest neighbours, and XGBoost, were compared for our task. Based on the optimal classifier, we compared the performance of clinical, fractal, and radiomic models and the model combining these features in predicting teratomas. RESULTS Among the diagnostic models, the fractal and radiomic models performed better than the clinical model. The final model that combined all the features showed the best performance, with an area under the curve, precision, sensitivity, and specificity of 0.946 [95% confidence interval (CI): 0.882-0.994], 95.65% (95% CI: 88.64-100%), 88.00% (95% CI: 77.78-96.36%), and 91.67% (95% CI: 78.26-100%), respectively, in the test set of the discovery set, and 0.944 (95% CI: 0.855-1.000), 85.71% (95% CI: 68.18-100%), 94.74% (95% CI: 83.33-100%), and 80.00% (95% CI: 58.33-100%), respectively, in the independent validation set. SHapley Additive exPlanations indicated that two fractal features, two radiomic features, and age were the top five features highly associated with the presence of teratomas. CONCLUSION The predictive model including image and clinical features could help guide treatment strategies for IGCTs. CLINICAL RELEVANCE STATEMENT Our machine learning model including image and clinical features can non-invasively predict teratoma components, which could help guide treatment strategies for intracranial germ cell tumours (IGCT). KEY POINTS • Fractals and radiomics can quantitatively evaluate imaging characteristics of intracranial germ cell tumours. • Model combing imaging and clinical features had the best predictive performance. • The diagnostic model could guide treatment strategies for intracranial germ cell tumours.
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Affiliation(s)
- Shuai Liu
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Xianyu Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Xing Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shaowu Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hongen Liao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China.
| | - Xiaoguang Qiu
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
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Arbel EJ, Dinerman BF, Rutkowski J, Acosta AM, Spencer J. Primary testicular teratoid Wilms tumor in a 40-year-old male with retroperitoneal lymph node involvement: A case report. Urol Case Rep 2024; 53:102701. [PMID: 38495851 PMCID: PMC10944175 DOI: 10.1016/j.eucr.2024.102701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
We report a 40-year-old male presenting with right testicular pain. Following right orchiectomy demonstrating pT1bS0N0M0 teratoma with extensive necrosis, the patient opted for surveillance. With new retroperitoneal lymphadenopathy, the patient underwent a robotic-assisted laparoscopic retroperitoneal lymph node. After final pathology demonstrated extensive necrosis, the initial orchiectomy specimen was re-reviewed which revealed 60/40 ratio of non-seminomatous teratoma to nephroblastoma. Adult presentation of testicular nephroblastoma is exceedingly rare and such reports contribute to the understanding of adult teratoid Wilms tumor pathogenesis. This case emphasizes the need for comprehensive diagnostic approaches and further research into the pathophysiology of extrarenal teratoid Wilms tumors.
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Affiliation(s)
- Eylon J. Arbel
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Brian F. Dinerman
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Department of Urology, Buffalo, NY, USA
| | - John Rutkowski
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Department of Urology, Buffalo, NY, USA
| | - Andrés M. Acosta
- Indiana University School of Medicine, Department of Pathology, Indianapolis, IN, USA
| | - Jeffrey Spencer
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Department of Urology, Buffalo, NY, USA
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15
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Fonini JS, de Araujo PHXN, D'Ambrosio PD, Salerno JVDO, Ciaralo PPD, Terra RM, Pêgo-Fernandes PM. Prolonged survival after thoracic metastasectomy in patients with nonseminomatous testicular cancer. Clinics (Sao Paulo) 2024; 79:100338. [PMID: 38359698 PMCID: PMC10877677 DOI: 10.1016/j.clinsp.2024.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/18/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Almost 20 % of patients with Non-Seminomatous Germinative Cell Tumors (NSGCT) will require intrathoracic metastasectomy after chemotherapy. The authors aim to determine their long-term survival rates. METHODS Retrospective study including patients with NSGCT and intrathoracic metastasis after systemic therapy from January 2011 to June 2022. Treatment outcomes and overall survival were analyzed with the Kaplan-Meier method. RESULTS Thirty-seven male patients were included with a median age of 31.8 years. Six presented with synchronous mediastinum and lung metastasis, nine had only lung, and 22 had mediastinal metastasis. Over half had retroperitoneal lymph node metastasis. Twenty-two had dissimilar pathologies, with a discordance rate of 62 %. Teratoma and embryonal carcinoma were the prevalent primary tumor types, 40.5 % each, while teratoma was predominant (70.3 %) in the metastasis group. Thoracotomy was the main surgical approach (39.2 %) followed by VATS (37.2 %), cervico-sternotomy (9.8 %), sternotomy (5.8 %), and clamshell (3.9 %). Lung resection was performed in 40.5 % of cases. Overall, 10-year survival rates were 94.3 % with no surgical-related mortality. CONCLUSION Multimodality treatment with systemic therapy followed by radical surgery offers a high cure rate to patients with intrathoracic metastatic testicular germ cell tumors.
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Affiliation(s)
- Jaqueline Schaparini Fonini
- Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
| | - Pedro Henrique Xavier Nabuco de Araujo
- Thoracic Surgical Oncology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Thoracic Surgical Oncology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Paula Duarte D'Ambrosio
- Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | | | - Pedro Prosperi Desenzi Ciaralo
- Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Ricardo Mingarini Terra
- Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Paulo Manuel Pêgo-Fernandes
- Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
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Venishetty N, Taylor J, Xi Y, Howard JM, Ng YS, Wong D, Woldu SL, De Leon AD, Pedrosa I, Margulis V, Bagrodia A. Testicular Radiomics To Predict Pathology At Time of Postchemotherapy Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Tumor. Clin Genitourin Cancer 2024; 22:33-37. [PMID: 37468341 DOI: 10.1016/j.clgc.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Testicular germ cell tumors are the most common malignancy in young adult males. Patients with metastatic disease receive standard of care chemotherapy followed by retroperitoneal lymph node dissection for residual masses >1cm. However, there is a need for better preoperative tools to discern which patients will have persistent disease after chemotherapy given low rates of metastatic germ cell tumor after chemotherapy. The purpose of this study was to use radiomics to predict which patients would have viable germ cell tumor or teratoma after chemotherapy at time of retroperitoneal lymph node dissection. PATIENTS AND METHODS Patients with nonseminomatous germ cell tumor undergoing postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) between 2008 and 2019 were queried from our institutional database. Patients were included if prechemotherapy computed tomography (CT) scan and postchemotherapy imaging were available. Semiqualitative and quantitative features of residual masses and nodal regions of interest and radiomic feature extractions were performed by 2 board certified radiologists. Radiomic feature analysis was used to extract first order, shape, and second order statistics from each region of interest. Post-RPLND pathology was compared to the radiomic analysis using multiple t-tests. RESULTS 45 patients underwent PC-RPLND at our institution, with the majority (28 patients) having stage III disease. 24 (53%) patients had teratoma on RPLND pathology, while 2 (4%) had viable germ cell tumor. After chemotherapy, 78%, 53%, and 33% of patients had cystic regions, fat stranding, and local infiltration present on imaging. After radiomic analysis, first order statistics mean, median, 90th percentile, and root mean squares were significant. Strong correlations were observed between these 4 features;a lower signal was associated with positive pathology at RPND. CONCLUSIONS Testicular radiomics is an emerging tool that may help predict persistent disease after chemotherapy.
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Affiliation(s)
- Nikit Venishetty
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX
| | - Jacob Taylor
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Yin Xi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Yee Seng Ng
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Daniel Wong
- Department of Urology, Washington University School of Medicine, St. Louis, MO
| | - Solomon L Woldu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alberto Diaz De Leon
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ivan Pedrosa
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Aditya Bagrodia
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, University of California San Diego Health, San Diego, CA.
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Beutler BD, Moody AE, Thomas JM, Sugar BP, Ulanja MB, Antwi-Amoabeng D, Tsikitas LA. Anti-N-methyl-D-aspartate receptor-associated encephalitis: A review of clinicopathologic hallmarks and multimodal imaging manifestations. World J Radiol 2024; 16:1-8. [PMID: 38312349 PMCID: PMC10835429 DOI: 10.4329/wjr.v16.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/04/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Anti-N-methyl-D-aspartate receptor-associated encephalitis (NMDARE) is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction. The mechanism of pathogenesis remains incompletely understood, but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways. Young adults are most frequently affected; the median age at diagnosis is 21 years. There is a strong female predilection with a female sex predominance of 4:1. NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma. However, NMDARE has also been described in patients with small cell lung cancer, clear cell renal carcinoma, and other benign and malignant neoplasms. Diagnosis is based on correlation of the clinical presentation, electroencephalography, laboratory studies, and imaging. Computed tomography, positron emission tomography, and magnetic resonance imaging are essential to identify an underlying tumor, exclude clinicopathologic mimics, and predict the likelihood of long-term functional impairment. Nuclear imaging may be of value for prognostication and to assess the response to therapy. Treatment may involve high-dose corticosteroids, intravenous immunoglobulin, and plasma exchange. Herein, we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria, treatment regimens, and proposed pathogenetic mechanisms.
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Affiliation(s)
- Bryce David Beutler
- Department of Radiology, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States
| | - Alastair E Moody
- Department of Anesthesiology, University of Utah, Salt Lake City, UT 84132, United States
| | - Jerry Mathew Thomas
- Department of Radiology, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States
| | - Benjamin Phillip Sugar
- Department of Radiology, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States
| | - Mark B Ulanja
- Department of Internal Medicine, Christus Ochsner St. Patrick Hospital, Lake Charles, LA 70601, United States
| | - Daniel Antwi-Amoabeng
- Department of Internal Medicine, Christus Ochsner St. Patrick Hospital, Lake Charles, LA 70601, United States
| | - Lucas Anthony Tsikitas
- Department of Radiology, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States
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Grisales-Gallo JE, Salinas-Castro KJ, Nasner D, Toro-Gutiérrez JS. Mature cystic teratoma overlapping with giant serous cystadenoma of the ovary: A case report. Radiol Case Rep 2024; 19:218-222. [PMID: 38028279 PMCID: PMC10651425 DOI: 10.1016/j.radcr.2023.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Ovarian lesions represent a diagnostic challenge for the radiologist and should be approached according to the patient's age, menstrual cycle, and imaging characteristics. These lesions can be cystic, mixed, or solid-predominant structures. Generally, the occurrence of benign lesions surpasses that of malignant ones at a ratio of 3:1. However, within infantile and juvenile age groups, this becomes an infrequent occurrence, making up only about 5% of ovarian tumor cases. This case report sheds light on a unique scenario involving a pediatric patient who harbored 2 benign tumors simultaneously: a mature cystic teratoma and a serous cystadenoma.
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Affiliation(s)
| | | | - Daniela Nasner
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
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González Murillo EA, Benavides Salas E, Vizcaino Lozano MM. [Low-grade astrocytoma within a retroperitoneal teratoma: Case report]. Rev Esp Patol 2024; 57:71-74. [PMID: 38246715 DOI: 10.1016/j.patol.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 01/23/2024]
Abstract
Teratomas are neoplasms originate from germ cells and can undergo malignant transformation, the World Health Organization (WHO) classified them as teratoma with somatic-type malignancy which is uncommon and sarcomas are the histological type with the highest incidence. It is important to identify this type of tumors because influences the prognosis and survival of the patient. We present the case of a 5-month-old male, who began his condition at one month-old with constipation and increase of the abdominal circumference, imaging studies revealed an abdominal lesion, he was treated with chemotherapy and surgery. The histopathological report was immature teratoma, grade 1, with a focus of nervous tissue showing characteristics of low-grade astrocytoma.
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Affiliation(s)
- Eduardo Alfredo González Murillo
- Departamento de Anatomía Patológica, UMAE Hospital de Especialidades No. 25. Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
| | - Eduardo Benavides Salas
- Departamento de Anatomía Patológica, UMAE Hospital de Especialidades No. 25. Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
| | - María Margarita Vizcaino Lozano
- Departamento de Anatomía Patológica, UMAE Hospital de Especialidades No. 25. Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México.
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Chi XT, Tian J, Zhao XY, Zhang XY, Xu C, Deng K. PET/CT Examination of Teratomas after Stem Cell Transplantation for a Spinal Cord Injury: A Case Report. Curr Med Imaging 2024; 20:1-7. [PMID: 38389353 DOI: 10.2174/0115734056264182231115104635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/09/2023] [Accepted: 10/06/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND In clinical practice, stem cell transplantation has become an effective method for treating spinal cord nerve injury. Up to now, there has been no report on teratoma caused by transplanted stem cell's abnormal differentiation in the clinic, especially in the analysis of imaging manifestations. Therefore, this article aims to analyze the PET/CT imaging manifestations of teratoma caused by stem cell transplantation to improve the imaging diagnosing capability. CASE PRESENTATION A patient with a spinal cord injury who had received a stem cell transplant was examined by PET/CT on September 10th, 2020. The PET/CT images of the lesion showed irregular mixed low density on the right side of the erector spinae muscle area at the level of the cervical 3-5 vertebral body, with a maximum cross-section of 9.1×3.9 cm. The 18F-FDG metabolism of the lesion was increased, and the maximum standard uptake value (SUVmax) was 10.7. The boundary was unclear with the third cervical vertebra and cervical 3 and 4-level vertebral plates. Based on the patient's medical history, the lesion was diagnosed as an abnormal proliferative tumor, which was consistent with the pathological examination results. CONCLUSION To date, there have been no clinical reports on teratomas caused by stem cell transplantation for spinal cord injury at home or abroad. This case report enhances the knowledge of the diagnosis and treatment methods of this type of disease and confirms the diagnostic value of PET/CT examination.
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Affiliation(s)
- Xiao-Tong Chi
- Department of Nuclear Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250013, China
| | - Jun Tian
- Department of Nuclear Medicine, The 960th of PLA, Jinan, Shandong 250000, China
| | - Xiu-Yi Zhao
- Department of Nuclear Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250013, China
| | - Xiao-Yan Zhang
- Department of Radiology, The First Affiliated Hospital Of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong 250014, China
| | - Chen Xu
- Department of Radiology, The First Affiliated Hospital Of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong 250014, China
| | - Kai Deng
- Department of Radiology, The First Affiliated Hospital Of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong 250014, China
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21
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Sorge I, Hirsch FW. [Ovarian masses in infants and children]. Radiologie (Heidelb) 2024; 64:26-34. [PMID: 37947867 DOI: 10.1007/s00117-023-01233-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Abnormalities of the ovary are frequently seen on ultrasound examination, sometimes symptomatic, but are more commonly asymptomatic. PURPOSE Presentation of the most important entities of ovarian masses and their imaging features in infants and children. Discussion of criteria for differentiation between benign and potentially malignant masses. MATERIALS AND METHODS Review of current literature and presentation of image examples. RESULTS The most common lesions are ovarian cysts in infants, which usually do not require therapy. Because of the risk of torsion, surgery should be discussed for lesions with a size of 5 cm or more. Benign teratomas represent three-quarters of all solid tumors of the infantile ovary. Malignant masses are rare. The task of imaging is to assess the potential risk of malignancy, also using imaging scores. CONCLUSIONS Imaging plays a crucial role for therapeutic considerations. Depending on the potential risk, ovarian-sparing surgery is preferred to preserve fertility, as long as the oncologic risk is reasonable.
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Affiliation(s)
- Ina Sorge
- Institut für Kinderradiologie, Universitätsklinik Leipzig, Liebigstr. 20 a, 04103, Leipzig, Deutschland.
| | - Franz Wolfgang Hirsch
- Institut für Kinderradiologie, Universitätsklinik Leipzig, Liebigstr. 20 a, 04103, Leipzig, Deutschland
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22
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Kawaguchi M, Kato H, Furui T, Noda Y, Hyodo F, Miyazaki T, Matsuo M. MRI findings of malignant transformation arising from mature cystic teratoma of the ovary: comparison with benign mature cystic teratoma. Jpn J Radiol 2023:10.1007/s11604-023-01521-z. [PMID: 38146022 DOI: 10.1007/s11604-023-01521-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/26/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of MRI findings to differentiate malignant transformation arising from mature cystic teratoma (MT-MCT) of the ovary from benign mature cystic teratoma (BMCT). MATERIALS AND METHODS This study included 11 patients with histopathologically proven MT-MCT and 50 with BMCT. Overall, 7 patients with MT-MCT and all 50 with BMCT underwent unenhanced and contrast-enhanced MRIs and 4 with MT-MCT only underwent unenhanced MRIs. The MRI findings were evaluated and compared between the two diseases. RESULTS The median age (55 vs. 38 years, p < 0.01) and maximum diameter (109 vs. 65 mm, p < 0.01) were higher in MT-MCT than in BMCT. Fat component occupancy was lower in MT-MCT than in BMCT (median, 5% vs. 63%, p < 0.01). Only MT-MCT exhibited irregular tumor margins (64%), peritoneal dissemination (18%), and abnormal ascites (27%). The solid components were more commonly observed in MT-MCT than in BMCT (100% vs. 32%, p < 0.01) on contrast-enhanced images. The maximum diameter of solid components in MT-MCT was larger than that in BMCT (median, 61 mm vs. 14 mm, p < 0.01). In MT-MCT, the common configuration of solid components was endophytic or exophytic sessile (85%), whereas in BMCT, it was endophytic papillary (88%). CONCLUSION Compared with BMCT, MT-MCT demonstrated a larger maximum diameter, lower occupancy rate of fat components, and sessile solid components. The characteristic configuration of solid components was endophytic or exophytic sessile in MT-MCT and endophytic papillary in BMCT.
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Affiliation(s)
- Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
- Department of Radiology, Ogaki Municipal Hospital, 4-86 Minaminokawacho, Ogaki, 503-0864, Japan.
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University, Gifu, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
- Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Gifu, Japan
| | | | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
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23
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Elhamrawy A, Syed A, Tobias JD. Anesthetic Care During Exploratory Laparotomy and Excision of a Fetus-in-Fetu With a Combined General-Regional Anesthetic Technique Using a Caudal Epidural Catheter. J Med Cases 2023; 14:393-399. [PMID: 38186560 PMCID: PMC10769655 DOI: 10.14740/jmc4164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/20/2023] [Indexed: 01/09/2024] Open
Abstract
Fetus-in-fetu (FIF) is a rare, congenital anomaly involving the presence of one of a pair of twins within the body of the other. It is postulated that this pathology occurs during embryogenesis of a diamniotic-monochorionic twin pregnancy with unequal division of the blastocele, which results in monozygotic, monochorionic, and diamniotic twins of unequal sizes. Presentation as an abdominal mass during the neonatal period or infancy is most common, although late diagnosis during the adult years may also occur. We report a 1-day-old, full-term female neonate who presented for exploratory laparotomy and excision of a FIF. We present the use of a combined general-regional technique using caudal epidural anesthesia. The etiology, presentation, appropriate workup, and treatment of FIF are presented. Previous anecdotal reports of anesthetic care for excision of FIF are reviewed.
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Affiliation(s)
- Amr Elhamrawy
- Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Ahsan Syed
- Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Joseph D. Tobias
- Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
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24
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Wénin J, Bronchain M, Sellimi A, van Pesch V. Anti-NMDA-receptor encephalitis, a challenging case leading to the discovery of a rapidly growing tumor. Acta Neurol Belg 2023; 123:2413-2415. [PMID: 36940061 DOI: 10.1007/s13760-023-02241-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Affiliation(s)
- Julie Wénin
- Cliniques Universitaires Saint Luc, UCLouvain, Neurology Departement, Brussels, Belgium.
| | - Maroussia Bronchain
- Cliniques Universitaires Saint Luc, UCLouvain, Neurology Departement, Brussels, Belgium
| | - Amina Sellimi
- Cliniques Universitaires Saint Luc, UCLouvain, Neurology Departement, Brussels, Belgium
| | - Vincent van Pesch
- Cliniques Universitaires Saint Luc, UCLouvain, Neurology Departement, Brussels, Belgium
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25
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Bouassida I, Ayed AB, Ouhichi S, Saad A, Zairi S, Marghli A. A huge mediastinal teratoma in a 14-year-old girl. Int J Surg Case Rep 2023; 113:109003. [PMID: 37952494 PMCID: PMC10681936 DOI: 10.1016/j.ijscr.2023.109003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Mediastinal teratoma is the most common mediastinal germ cell tumor. Mature mediastinal teratomas are infrequent and often found incidentally. CASE PRESENTATION We report the case of a 14-year-old girl who was presented dyspnea for 2 years. A computed tomography of the chest revealed a 19 cm heterogenous right-sided anterior mediastinal mass suggesting mature teratoma. The mass compressed vital structures. The tumor was considered resectable. By hemiclamshell approach, we punctured the tumor and aspirated its contents. The tumor was totally resected en bloc with a cuff of pericardium, phrenic nerve and azygos vena. The pericardial defect was repaired using Mersilene mesh. Histopathology of the tumor revealed a mature cystic teratoma. Postoperative course was uneventful. CLINICAL DISCUSSION Complete surgical excision is the treatment of choice for mediastinal mature teratoma. The choice of incision for removing the tumor depend on the tumor size, location and the relashionships with the associated vital structures. Lengthy incisions were required for the safe mobilization of the tumor. In addition, contents aspiration through a small incision in the giant tumor wall helped improve tumor mobilization. CONCLUSION Appropriate surgical strategy for a well selected case maintains functional status and results total tumor resection.
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Affiliation(s)
- Imen Bouassida
- Department of Thoracic Surgery, AbderrahmaneMami Hospital, Ariana, Tunisia
| | - Aymen Ben Ayed
- Department of Thoracic Surgery, AbderrahmaneMami Hospital, Ariana, Tunisia.
| | - Sabrine Ouhichi
- Department of pneumology, Pavillon B AbderrahmanMami Hospital, Ariana, Tunisia
| | - Asma Saad
- Department of Thoracic Surgery, AbderrahmaneMami Hospital, Ariana, Tunisia
| | - Sarra Zairi
- Department of Thoracic Surgery, AbderrahmaneMami Hospital, Ariana, Tunisia
| | - Adel Marghli
- Department of Thoracic Surgery, AbderrahmaneMami Hospital, Ariana, Tunisia
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26
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Wang Y, Deng L, Qin D, Zhang X. A rare case of borderline struma ovarii. Asian J Surg 2023; 46:5607-5608. [PMID: 37612181 DOI: 10.1016/j.asjsur.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/06/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Yiting Wang
- Department of Radiology, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian, 116023, PR China
| | - Lanxin Deng
- Department of Radiology, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian, 116023, PR China
| | - Dongxue Qin
- Department of Radiology, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian, 116023, PR China.
| | - Xiyou Zhang
- Department of Radiology, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian, 116023, PR China.
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27
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Jeong CH. Mature Cystic Teratoma of the Ovary Transforms into Squamous Cell Carcinoma: A Case Report. J Menopausal Med 2023; 29:146-149. [PMID: 38230600 PMCID: PMC10796199 DOI: 10.6118/jmm.23036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024] Open
Abstract
Mature cystic teratomas (MCTs) are benign ovarian tumors known to undergo malignant transformation in 1%-2% of cases. Most of these cases lead to squamous cell carcinomas (SCC), and the prognosis is often poor, particularly in advanced-stage disease. A 50-year-old postmenopausal woman presented with a large pelvic mass. The patient initially underwent suboptimal primary surgery and was later diagnosed with stage IIIA SCC arising from MCT. Following the first cycle of chemotherapy with carboplatin and paclitaxel, a computed tomography scan showed a rapidly growing large mass in the pelvic cavity after 4 weeks of primary surgery, leading to a second debulking surgery. However, the patient underwent only one cycle of chemotherapy after secondary debulking surgery because of her poor performance status. Subsequently, after 4 months of secondary debulking surgery, the patient developed rapidly progressive disease, leading to her death approximately after 8 months of diagnosis. While an appropriate multimodal treatment strategy has yet to be established, optimal cytoreductive surgery and adjuvant chemotherapy should be considered for treatment of advanced-stage diseases to improve survival outcomes.
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Affiliation(s)
- Chul Hoi Jeong
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Busan, Korea.
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28
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Zhou H, Li X, Chen J, Ding Y, Ma X, Lai C, Fu J. Development and validation of a nomogram for preoperative prediction of immature teratoma in children with teratoma: a retrospective, multicenter, diagnostic study. Quant Imaging Med Surg 2023; 13:8067-8078. [PMID: 38106326 PMCID: PMC10722040 DOI: 10.21037/qims-23-600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/18/2023] [Indexed: 12/19/2023]
Abstract
Background Teratomas are the most common germ cell tumors in children, and histologically classified as mature teratomas (MTs) and immature teratomas (ITs). Preoperative IT identification can affect the surgical approach, the type of procedure, and future possible reproductive health. However, there is no complete diagnostic criterion for ITs nowadays. We aimed to establish and validate a nomogram based on clinical and computed tomography (CT) features for preoperative prediction of ITs in children. Methods We retrospectively reviewed 519 teratoma patients from hospital I for training (n=364) and validation (n=155), and 113 patients from hospital II for external validation. Univariate and multivariate logistic regression analyses were performed on the training set to screen risk factors, including alpha-fetoprotein (AFP), age, gender, tumor site, size, tumor composition, calcification and fat. Then, a nomogram was established based on identified risk factors and validated on the validation set. The performance of the nomogram was evaluated in terms of discrimination, calibration and the clinical usefulness. Results Multivariate logistic regression showed that tumor composition, AFP, age, calcification and fat were independent risk factors for preoperative prediction of IT. The area under the receiver operating characteristic (ROC) curves (AUCs) for the nomogram on the training set, internal and external validation set were 0.92 (0.88-0.96), 0.91 (0.84-0.97) and 0.92 (0.86-0.97), respectively. The model demonstrated sensitivity of 80%, specificity of 90% at the cut-off value of 0.262. Whatever the set, the calibration curve indicated good calibration. Decision curve analysis (DCA) curves demonstrated that the nomogram had greater net benefits than either the treat-all tactics or the treat-none tactics within a large scope of threshold. Conclusions The nomogram established based on clinical and CT findings had the favorable accuracy for the preoperative prediction of IT, and may help in clinical decision-making and risk stratification.
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Affiliation(s)
- Haichun Zhou
- Department of Radiology, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Xu Li
- Department of Radiology, Children’s Hospital of Anhui Medical University, Hefei, China
| | - Jing Chen
- Department of Medical Imaging, Tianjin Children’s Hospital, Tianjin, China
| | - Yushuang Ding
- Department of Radiology, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Xiaohui Ma
- Department of Radiology, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Can Lai
- Department of Radiology, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Junfen Fu
- Department of Endocrinology, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
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29
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Fichtner A, Bremmer F. [Fundamentals in the pathology of testicular germ cell tumours]. Pathologie (Heidelb) 2023; 44:401-413. [PMID: 37737316 DOI: 10.1007/s00292-023-01223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 09/23/2023]
Abstract
Testicular germ cell tumours (GCT) represent the most common malignant neoplasia in young male adults between the age of 15 and 44. Because of their different biological behaviour it is important to differentiate prepubertal GCTs from postpubertal GCTs. This distinction is made by presence or absence of a germ cell neoplasia in situ. Histopathological diagnostics can be challenging due to different tumour subtypes and their different growth patterns. Therefore, knowledge of morphologic variants and immunohistochemical markers is important.
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Affiliation(s)
- Alexander Fichtner
- Institut für Pathologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37073, Göttingen, Deutschland
| | - Felix Bremmer
- Institut für Pathologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37073, Göttingen, Deutschland.
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30
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Mardani P, Kamran H, Ghaderpanah R, Geramizadeh B, Fouladi D, Shahriarirad R, Amirian A. A massive immature mediastinal teratoma treated with chemotherapy and surgical resection: a case report. J Cardiothorac Surg 2023; 18:294. [PMID: 37845684 PMCID: PMC10580578 DOI: 10.1186/s13019-023-02389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/30/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Teratoma is a type of germ cell tumor consisting of one or multiple tissues derived from germinal layers. The location and size of the tumor can cause various presentations. Here we report one of the largest ever cases of immature cystic teratoma. CASE PRESENTATION In this report, we presented a 24-year-old patient with dyspnea, chest pain, nausea, and anorexia. A computed tomography scan revealed a giant, right-sided mass measuring about 190 × 150 × 140 mm. Chemotherapy was initiated for the patient, followed by thoracotomy. Histopathological evaluation revealed the nature of the mass to be an immature mediastinal teratoma. CONCLUSION the incidence of immature mediastinal teratoma is uncommon, and due to its rarity, the diagnosis needs more profound evaluation studies such as radiological and pathological assessments. Immature teratomas are optimally treated by a combination of chemotherapy and complete resection.
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Affiliation(s)
- Parviz Mardani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Hooman Kamran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rezvan Ghaderpanah
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- Shiraz Transplant Research Center (STRC), Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damoun Fouladi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Armin Amirian
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
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31
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Peeters SM, Uhr L, Chivukula S, McBride D, Everson R, Duong D, Yang I, Cornford M, Mlikotic A, Yong W, Kim W. Cervicomedullary junction mature teratoma with pulmonary differentiation and diastematomyelia in an adult - A rare case. Surg Neurol Int 2023; 14:334. [PMID: 37810313 PMCID: PMC10559391 DOI: 10.25259/sni_633_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/15/2023] [Indexed: 10/10/2023] Open
Abstract
Background Intradural extramedullary teratomas in the cervical or cervicomedullary region are rare in adults. Case Description We report a symptomatic, mature teratoma at the cervicomedullary junction in a 52-year-old Hispanic female who also has a type I diastematomyelia in the thoracolumbar spine. The patient underwent surgical resection of the lesion with the resolution of presenting symptoms. Histopathology of the lesion revealed a mature cystic teratoma with pulmonary differentiation. Conclusion We discuss the case along with a review of pertinent literature and considerations with regard to the diagnosis, etiology, prognosis, and management of this unusual pathology.
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Affiliation(s)
- Sophie M. Peeters
- Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States
| | - Lauren Uhr
- Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States
| | - Srinivas Chivukula
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Duncan McBride
- Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States
| | - Richard Everson
- Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States
| | - Duc Duong
- Department of Neurosurgery, Harbor UCLA Medical Center, Torrance, United States
| | - Isaac Yang
- Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States
| | - Marcia Cornford
- Department of Pathology, Harbor UCLA Medical Center, Torrance, United States
| | - Anton Mlikotic
- Department of Radiology, Harbor UCLA Medical Center, Torrance, United States
| | - William Yong
- Department of Pathology, UCLA, Los Angeles, California, United States
| | - Won Kim
- Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States
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32
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Desita F, Mardiyana L. Typical and atypical magnetic resonance imaging manifestation of ovarian mature cystic teratomas: A report of two cases. Radiol Case Rep 2023; 18:2948-2954. [PMID: 37520391 PMCID: PMC10375376 DOI: 10.1016/j.radcr.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 08/01/2023] Open
Abstract
The mature teratoma, also known as a dermoid cyst, is the most common type of ovarian teratoma (OT). They constitute 95% of all teratomas and 69% of germ cell tumors, and their heterogeneity leads to various clinical manifestations with a wide range of imaging presentations. We presented 2 patients undergoing pelvic magnetic resonance imaging (MRI) showing a mature cystic teratoma and pathologic examination confirming typical and atypical findings.
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Affiliation(s)
- Fallis Desita
- Department of Radiology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Jalan Mayjen. Prof. Dr. Moestopo 47, Surabaya 60131, Indonesia
| | - Lies Mardiyana
- Department of Radiology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Jalan Mayjen. Prof. Dr. Moestopo 47, Surabaya 60131, Indonesia
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de Oliveira PAM, Faustino-Rocha AI, da Costa RMG, Gonçalves EN, Calado AM, Baptista CJ, Gama A, Seixas F. A spontaneous ovarian teratoma in an FVB/n female mouse: Case report and literature review. Open Vet J 2023; 13:1223-1227. [PMID: 37842105 PMCID: PMC10576586 DOI: 10.5455/ovj.2023.v13.i9.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/25/2023] [Indexed: 10/17/2023] Open
Abstract
Background Teratomas are rare types of germ cell neoplasms composed of various differentiated or undifferentiated tissues. Case Description A 25-week-old female control FVB /n mouse in a 4-week toxicity study presented abdominal distension and poor body condition. It was euthanized, and the necropsy examination revealed a large mass connected to the tip of the right uterine horn, occupying the entire abdominal cavity. Microscopically, this mass showed areas of epidermal differentiation, with laminated keratin and sebaceous glands, differentiation into respiratory and digestive epithelium, cartilage, bone, and extensive areas of differentiation into the nervous tissue, being classified as an ovarian teratoma. Conclusion As far as authors know, the occurrence of ovarian teratomas in the FVB/n mouse strain has never been previously described.
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Affiliation(s)
- Paula Alexandra Martins de Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Vila Real, Portugal
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, UTAD, Vila Real, Portugal
| | - Ana I. Faustino-Rocha
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Vila Real, Portugal
- Department of Zootechnics, School of Sciences and Technology, University of Évora, Évora, Portugal
- Comprehensive Health Research Center, Évora, Portugal
| | - Rui M. Gil da Costa
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Vila Real, Portugal
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal
- Biomedicine Research Center (CEBIMED), Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculty of Engineering, University of Porto, Porto, Portugal
- Associate Laboratory in Chemical Engineering (ALiCE), Faculty of Engineering, University of Porto, Porto, Portugal
| | - Elisabete Nascimento Gonçalves
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Vila Real, Portugal
| | - Ana Margarida Calado
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, UTAD, Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Animal and Veterinary Research Centre (CECAV), UTAD, Vila Real, Portugal
| | - Catarina Jota Baptista
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Vila Real, Portugal
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, UTAD, Vila Real, Portugal
- Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
- Faculty of Veterinary Medicine, Lusophone University of Humanities and Technologies, Lisbon, Portugal
| | - Adelina Gama
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, UTAD, Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Animal and Veterinary Research Centre (CECAV), UTAD, Vila Real, Portugal
| | - Fernanda Seixas
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, UTAD, Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Animal and Veterinary Research Centre (CECAV), UTAD, Vila Real, Portugal
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M SC, Peethambar BA. Mature cystic teratoma without intratumoral fat: A diagnostic dilemma. Radiol Case Rep 2023; 18:3109-3112. [PMID: 37416320 PMCID: PMC10319638 DOI: 10.1016/j.radcr.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Teratomas are the most common benign ovarian neoplasms in young women. Typical computed tomography imaging findings include fat, fat fluid level, tooth or calcification, rokitansky nodule, floating balls sign, and tufts of hair. They can have unusual imaging features leading to diagnostic dilemmas. Studies have shown the presence of intratumoral fat to be specific to ovarian cystic teratoma. However, there are reports in the literature of mature cystic teratoma that do not contain fat in the lumen of the cyst which can hinder an accurate diagnosis. They can be associated with various complications like torsion, rupture, malignant transformation, infection, and autoimmune hemolytic anemias. Presented here is a case of mature cystic teratoma without visible intracystic fat which underwent torsion.
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Affiliation(s)
- Sandra C M
- Department of Radiology, MES Medical College, Palachode Post, Perinthalmanna, Kerala, India
| | - Breman Anil Peethambar
- Madras Medical College and Government General Hospital, Emergency Department, Chennai, Tamil Nadu, India
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Al Bashir S, Alorjani MS, Haddad HK, Matalka MI, Obeidat N, Matalka II, Sobrinho-Simões M. Mature cystic teratoma of the ovary with malignant transformation of tall cell subtype of papillary thyroid carcinoma. Virchows Arch 2023; 483:251-254. [PMID: 37395743 DOI: 10.1007/s00428-023-03594-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/04/2023]
Abstract
Malignancies rarely occur in somatic parts of mature cystic teratoma of the ovary. Squamous cell carcinoma is the most common form of cancer that can develop in mature cystic teratoma. Other less frequent malignancies include melanoma, sarcoma, carcinoid, and germ cell neoplasms. Only three cases have been reported as papillary thyroid carcinoma arising in struma ovarii. We present a unique case of a 31-year-old female patient who presented with a left ovarian cyst and underwent conservative surgical management in the form of cystectomy. Histopathological examination confirmed the diagnosis of a tall cell subtype of papillary thyroid carcinoma arising from a small focus of thyroid tissue in a mature cystic teratoma of the ovary. The patient was followed up for 60 months with an uneventful clinical course. For a better understanding of such rare cancers, collaborative retrospective studies on large databases with other medical centers are required.
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Affiliation(s)
- Samir Al Bashir
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
| | - Mohammed S Alorjani
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Husam K Haddad
- Department of Pathology and Laboratory Medicine, Ministry of Health, Amman, Jordan
| | - Mohammad I Matalka
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nail Obeidat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ismail I Matalka
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Manuel Sobrinho-Simões
- Department of Pathology, Institute of Molecular Pathology and Immunology, IPATIMUP, University of Porto, Porto, Portugal
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Huang Y, Dong Y, Li P, Zhou C, Li WX, Li ZJ, Liu Y, Bao YH, Liao DF. Quantitative analysis of a posterior fossa teratomas with unusual CT and MR Characteristics--illustrative case. Heliyon 2023; 9:e18471. [PMID: 37560666 PMCID: PMC10407040 DOI: 10.1016/j.heliyon.2023.e18471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Intracranial teratomas or other cystic lesions with atypical imaging manifestations can still be frequently seen clinically. The specific reasons for unusual imaging manifestations need to be further explored. OBSERVATIONS A case of adult teratoma in the posterior fossa with unusual imaging manifestations was reported. The chemical composition of its cystic fluid was quantitatively detected, and in vitro imaging simulation experiments were performed on some fluid substances with similar cystic fluid properties to explore the reasons for special imaging manifestations. The content of inorganic substances and protein in the cystic fluid were both low, with no melanin detected. In vitro experiments revealed that MR T1 signals could increase with protein content rising and changes in MR T2 signals presented no obvious correlation with it. CT values increased gradually with protein concentration rising. The substances with similar viscosity had similar CT values, whereas substance viscosity showed no significant correlation with changes in MR signals. CONCLUSION The abnormality of imaging manifestations cannot be confirmed as the result of "high protein content", nor can it be simply attributed to bleeding. Further research is required for the impact of the combination of paramagnetic particles and biofluid on imaging.
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Affiliation(s)
- Ying Huang
- Department of Neurosurgery, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
- Key Laboratory for Quality Evaluation of Bulk Herbs of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
- China International Neuroscience Institute, Beijing, China
| | - Yu Dong
- Department of Neurosurgery, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
| | - Ping Li
- Department of Neurosurgery, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
| | - Chuan Zhou
- Department of Neurosurgery, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
| | - Wei-Xin Li
- Department of Neurosurgery, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
| | - Zai-Jun Li
- Medical Imaging Department, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
| | - Yi Liu
- Clinical Laboratory, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
| | - Yu-Hai Bao
- Department of Neurosurgery, Shenzhen Samii Medical Center, Shenzhen, Guangdong, China
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Duan-Fang Liao
- Key Laboratory for Quality Evaluation of Bulk Herbs of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
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Al Harthi S, Al Kalabni M, Al Qassabi B, Al Ajmi R. Mucinous Adenocarcinoma and Carcinoid Tumor Arising Within an Ovarian Mature Cystic Teratoma: A Case Report. Oman Med J 2023; 38:e538. [PMID: 37587986 PMCID: PMC10425607 DOI: 10.5001/omj.2023.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/30/2022] [Indexed: 08/18/2023] Open
Abstract
The coexistence of both mucinous adenocarcinoma and carcinoid tumor within an ovarian mature cystic teratoma is extremely rare. We report a case of an 18-year-old Omani woman with a left ovarian cyst. After laparotomy with left salpingo-oophorectomy, omentectomy, and peritoneal washings, the excised cyst had the typical morphology of mature cystic teratoma with grade I mucinous adenocarcinoma and a focus of carcinoid tumor.
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Affiliation(s)
- Sara Al Harthi
- Departments of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Moza Al Kalabni
- Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Badriya Al Qassabi
- Department of Radiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Radiya Al Ajmi
- Departments of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
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Lai PH, Ding DC. Ruptured teratoma mimicking a pelvic inflammatory disease and ovarian malignancy: A case report. World J Clin Cases 2023; 11:3852-3857. [PMID: 37383124 PMCID: PMC10294172 DOI: 10.12998/wjcc.v11.i16.3852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND We report a case of ruptured ovarian teratoma mimicking pelvic inflammatory disease (PID) and ovarian malignancy. The case indicates the need for reviewing the information on ovarian teratomas, as the symptoms are vague, and, therefore, diagnosis and treatment had to be structured accordingly.
CASE SUMMARY A 60-year-old woman was admitted to the emergency department with acute lower abdominal pain. She experienced weight loss and increased abdominal girth. Pelvic ultrasound and computed tomography revealed a 14-cm pelvic tumor. Laboratory examination revealed leukocytosis (white blood cell count: 12620/μL, segment: 87.7%) and high levels of C-reactive protein (18.2 mg/dL). Elevated levels of the tumor marker cancer antigen 19-9 (367.8 U/mL, normal value < 35 U/mL) were also noted. Due to the impression of a ruptured tubo-ovarian abscess or a tumor with malignancy, she immediately underwent an exploratory laparotomy. A ruptured ovarian tumor with fat balls, hair strands, cartilage, and yellowish fluid was observed on the right side. Right salpingo-oophorectomy was performed. A pathological examination revealed a mature cystic teratoma. The patient recovered after surgery and was discharged on post-operative day three. No antibiotics were administered.
CONCLUSION This case illustrates the differential diagnosis of an ovarian tumor. Therefore, surgery is the mainstay for treating a ruptured teratoma.
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Affiliation(s)
- Pei-Hsuan Lai
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Tzu Chi University, Hualien 970, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Tzu Chi University, Hualien 970, Taiwan
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Obana A, Sato Y, Matsumura T, Koyama M, Suwa T. Hand-assisted laparoscopic surgery on a gigantic primary retroperitoneal mature cystic teratoma: A case report. Int J Surg Case Rep 2023; 107:108370. [PMID: 37269761 DOI: 10.1016/j.ijscr.2023.108370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Primary teratomas in the retroperitoneum are rare, incidentally identified in children, and resected using a laparoscopic approach. However, when it increases in size, the laparoscopic approach is technically demanding, leaving a large skin incision for tumor removal. PRESENTATION OF CASE The patient was a 20-year-old woman who presented with chronic left flank pain. Abdominal and pelvic computed tomography (CT) revealed a 25-cm wide giant polycystic and solid retroperitoneal tumor containing calcification located in the upper portion of the left kidney, strongly compressing the pancreas and spleen. No other metastatic lesions were observed. Additionally, abdominal magnetic resonance imaging (MRI) revealed that the polycystic tumor consisted of serous fluid and fatty components, and bone and tooth components were found in the tumor center. Therefore, the patient was diagnosed with retroperitoneal mature teratoma and a hand-assisted laparoscopic surgery using bikini line skin incision was performed. The specimen was 27 × 25 cm in size, weighing 2512 g. Histology revealed that the tumor was a benign, mature teratoma without a malignant component. The postoperative course was uneventful and the patient was discharged on postoperative day 7. The patient remained healthy without any recurrence and the postoperative scar is barely visible under direct vision. DISCUSSION Primary retroperitoneal mature teratomas can enlarge without initially causing symptoms and can be incidentally identified using imaging studies. CONCLUSION A hand-assisted laparoscopic approach using a bikini line skin incision is safe, minimally invasive, and provides better cosmesis.
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Affiliation(s)
- Ayato Obana
- Department of Surgery, Kashiwa Kousei General Hospital, Japan.
| | - Yoshinobu Sato
- Department of Surgery, Kashiwa Kousei General Hospital, Japan
| | | | - Motoi Koyama
- Department of Surgery, Kashiwa Kousei General Hospital, Japan
| | - Tatsushi Suwa
- Department of Surgery, Kashiwa Kousei General Hospital, Japan
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Xiong PF, Yang L, Mou ZQ, Jiang Y, Li J, Ye MX. Giant teratoma with isolated intestinal duplication in adult: A case report and review of literature. World J Gastrointest Surg 2023; 15:978-983. [PMID: 37342858 PMCID: PMC10277953 DOI: 10.4240/wjgs.v15.i5.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/09/2023] [Accepted: 04/07/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND A combination of diseases is a rare phenomenon. Their clinical manifestations can vary, and the diagnosis can be challenging. Intestinal duplication is a rare congenital malformation, whereas retroperitoneal teratoma is a tumor in the retroperitoneal space, derived from the remaining embryonic tissue. There are relatively few clinical findings on adult retroperitoneal benign tumors. It is hard to believe that these two rare diseases can happen to the same person.
CASE SUMMARY A 19-year-old woman complaining of abdominal pain with nausea and vomiting was admitted. Abdominal computed tomography angiography was suggested for invasive teratoma. Intraoperative exploration revealed that the giant teratoma was connected to an isolated intestinal tract in the retroperitoneum. The postoperative pathological examination revealed that mature giant teratoma was present with intestinal duplication. This was a rare intraoperative finding that was successfully treated surgically.
CONCLUSION The clinical manifestations of intestinal duplication malformation are various, and difficult to diagnose before the operation. The possibility of intestinal replication should be considered when intraperitoneal cystic lesions are present.
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Affiliation(s)
- Ping-Fu Xiong
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Li Yang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhi-Qiang Mou
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Yu Jiang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Jing Li
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Ming-Xin Ye
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Awad Hegazy A, Ibraheem Al-Qtaitat A, Awad Hegazy R. A new hypothesis may explain human parthenogenesis and ovarian teratoma: A review study. Int J Reprod Biomed 2023; 21:277-284. [PMID: 37260553 PMCID: PMC10227352 DOI: 10.18502/ijrm.v21i4.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/24/2022] [Accepted: 02/28/2023] [Indexed: 06/02/2023] Open
Abstract
Parthenogenesis (PG) is a rare phenomenon occurring in humans, and understanding this may help us develop an explanation for such occurrences. Moreover, it may help reveal the cause of idiopathic ovarian teratoma (OT). We aim to explain the occurrence of PG and OT in humans based on a new hypothesis. Previous literature has been searched through relevant scientific websites and international journals on the causes and mechanisms of PG and OT in humans. The previous literature on human PG was sparse and mostly contained case reports. It appears that human PG is not as rare as previously reported but may occur spontaneously, resulting in OT formation. The difference between PG and sexual reproduction is that PG has no embryonic diversity. The biopsied embryonic samples in the PG correspond exclusively to those of the maternal side. Spontaneous PG in humans often degrades or leads to formation of OT. The cause and mechanism of spontaneous PG remain unclear in the available literature. Here, we hypothesized that in some cases the secondary oocyte and first polar body enclosed in the zona pellucida may fuse together to form a single cell that restores the diploid number of chromosomes and initiates cell division to form PG. It may go unnoticed or be represented by the OT. Future studies are recommended to investigate this hypothesis.
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Affiliation(s)
- Abdelmonem Awad Hegazy
- Faculty of Dentistry, Zarqa University, Zarqa City, Jordan
- Faculty of Medicine, Zagazig University, Zagazig City, Egypt
| | - Aiman Ibraheem Al-Qtaitat
- Faculty of Dentistry, Zarqa University, Zarqa City, Jordan
- Faculty of Medicine, Mutah University, Alkarak, Jordan
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Bougie E, Padeanu S, Plourde C, Aspirot A, Bouchard S, Brocks R, Caouette-Laberge L. It is all about form and function: a new approach to giant neonatal sacrococcygeal teratomas. Pediatr Surg Int 2023; 39:182. [PMID: 37071222 DOI: 10.1007/s00383-023-05454-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Giant sacrococcygeal teratomas (GSCTs) involve severe deformation of the buttock region in addition to potential functional impacts. Little interest has been given to improving the aesthetic post-operative appearance in children with these tumours. METHODS We describe a new technique for immediate reconstruction of GSCTs using buried dermal-fat flaps and a low transverse scar in the infragluteal fold. RESULTS Our technique allows wide exposure for tumour resection and functional restoration of the pelvic floor while placing the scars in anatomical locations and restoring buttock aesthetics including gluteal projection and infragluteal fold definition. CONCLUSION Reestablishment of function and form should be kept in mind at initial surgery in GSCT surgery to maximize results and enhance post-operative outcomes. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Emilie Bougie
- Division of Plastic and Reconstructive Surgery, Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada.
- Division of Plastic and Reconstructive Surgery, University of Montreal, Montreal, QC, Canada.
| | - Stefan Padeanu
- Division of Plastic and Reconstructive Surgery, University of Montreal, Montreal, QC, Canada
| | - Camille Plourde
- Division of Pediatric Surgery, Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada
| | - Ann Aspirot
- Division of Pediatric Surgery, Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada
| | - Sarah Bouchard
- Division of Pediatric Surgery, Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada
| | - Rebecca Brocks
- Division of Pediatric Surgery, Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada
| | - Louise Caouette-Laberge
- Division of Plastic and Reconstructive Surgery, Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada
- Division of Plastic and Reconstructive Surgery, University of Montreal, Montreal, QC, Canada
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Tekinhatun M, Ufuk F, Yılmaz M, Gurses D, Kis A, Ozturk G. Pericardial rupture of mediastinal mature cystic teratoma: An unusual cause of pediatric acute chest pain. Pediatr Pulmonol 2023; 58:1286-1288. [PMID: 36696145 DOI: 10.1002/ppul.26326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
A previously healthy 12-year-old girl presented to the emergency department with severe chest pain and dyspnea that woke her from sleep. She had short-term syncope just before the emergency admission. On physical examination, respiratory rate was 26 breaths per minute while resting, and blood pressure was 92/56 mmHg. Other physical examination findings were insignificant. She had no past medical history, and her family history was unremarkable. Laboratory test results showed elevated C-reactive protein (27 mg/L; reference range: <5 mg/L) and white blood cell count (13.7 K/μL; reference range: 4-12 K/μL). Other laboratory test results were within normal limits, including troponin T value (3 ng/L; reference range: 3-14 ng/L). An electrocardiogram showed 1 mm ST-segment elevation in bipolar (D1 and D2) limb leads, and augmented vector foot leads, and echocardiography revealed a complicated pericardial effusion and a suspicious mass adjacent to the left ventricle.
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Affiliation(s)
- Muhammed Tekinhatun
- Department of Radiology, University of Dicle, Diyarbakir, Turkey.,Department of Radiology, University of Pamukkale, Denizli, Turkey
| | - Furkan Ufuk
- Department of Radiology, University of Pamukkale, Denizli, Turkey
| | - Munevver Yılmaz
- Department of Pediatric Cardiology, University of Pamukkale, Denizli, Turkey
| | - Dolunay Gurses
- Department of Pediatric Cardiology, University of Pamukkale, Denizli, Turkey
| | - Argun Kis
- Department of Thoracic Surgery, University of Pamukkale, Denizli, Turkey
| | - Gokhan Ozturk
- Department of Thoracic Surgery, University of Pamukkale, Denizli, Turkey
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Light-Olson H, Niec JA, Zwaschka TA, Wong G, Ragheb D, Oros J, Correa H, Lopez ME, Stafman LL, Lovvorn HN. Minimally invasive adnexa-sparing surgery for benign ovarian and paratubal masses in children. J Pediatr Surg 2023; 58:702-707. [PMID: 36670003 DOI: 10.1016/j.jpedsurg.2022.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The precision of minimally invasive surgery (MIS) to resect benign ovarian and paratubal masses while preserving adnexa in children is unclear. This study evaluated the integrity of laparoscopy to spare adnexa while resecting benign pathologies in children. METHODS The institutional pathology database was queried to identify patients aged 18 years and younger having any ovarian or tubal lesion resected at a comprehensive children's hospital between 2006 and 2021. Adnexa-sparing surgery was defined as preserving both the ovary and tube from which the lesion was resected. Postoperative ultrasounds were reviewed to document ovarian follicles, blood flow, volumes, and lesion recurrence. RESULTS Adnexal preservation was implemented in 168 of 328 pathological resections. MIS approach was used in 149 cases. Median age was 13.4 [11.0-15.3]. Among sparing surgeries, MIS associated with benign pathology, shorter operative time (median minutes: 78 MIS [59-111.5]; 130 open [92.8-149.8]; 174 MIS-to-open [132.8-199.5]; p = 0.010), and reduced hospital stay (median days: 1 MIS (Lindfors, 1971; Lovvorn III et al., 1998) [1-2]; 2 open [2-2.9], 2 MIS-to-open [1-3.3]; p = 0.001). Postoperative ovarian volume ipsilateral to the MIS procedure (median, 7.6 ml [4.3-12.1]) was relatively smaller than the contralateral ovary (median, 9.1 ml [5.5-15.0]). Blood flow was documented to the ovary in 70/94 (74.4%) of patients after MIS adnexal-sparing surgery. Distinct follicles were detected in 48/74 (64.8%) of post-menarchal patients after MIS adnexal-sparing surgery. Five ovarian cysts recurred. CONCLUSIONS MIS preserves adnexa reliably, with postoperative ovarian follicles and blood flow detected in most patients, and maintains ∼80% of contralateral volume, while achieving definitive tumor resection. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Hannah Light-Olson
- Vanderbilt University School of Medicine, 1161 21st Ave S #D300, Nashville, TN, 37232, United States.
| | - Jan A Niec
- Vanderbilt University School of Medicine, 1161 21st Ave S #D300, Nashville, TN, 37232, United States
| | - Theresa A Zwaschka
- Vanderbilt University School of Medicine, 1161 21st Ave S #D300, Nashville, TN, 37232, United States
| | - Gunther Wong
- Vanderbilt University School of Medicine, 1161 21st Ave S #D300, Nashville, TN, 37232, United States
| | - Daniel Ragheb
- Vanderbilt University School of Medicine, 1161 21st Ave S #D300, Nashville, TN, 37232, United States
| | - Joseph Oros
- Division of Pediatric Radiology, Monroe Carrell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, 1211 Medical Center Drive, Nashville, TN, 37232, United States
| | - Hernan Correa
- Division of Pediatric Pathology, Monroe Carrell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, 1211 Medical Center Drive, Nashville, TN, 37232, United States
| | - Monica E Lopez
- Department of Pediatric Surgery, Monroe Carrell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, 1211 Medical Center Drive, Nashville, TN, 37232, United States
| | - Laura L Stafman
- Department of Pediatric Surgery, Monroe Carrell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, 1211 Medical Center Drive, Nashville, TN, 37232, United States
| | - Harold N Lovvorn
- Department of Pediatric Surgery, Monroe Carrell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, 1211 Medical Center Drive, Nashville, TN, 37232, United States
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Ren J, Zhang X, Zhang Z, Pan J, Hao Z, Li J, Liu J. Apoptosis inhibition enhances induced pluripotent stem cell generation during T cell reprogramming. Biochem Biophys Res Commun 2023; 656:30-37. [PMID: 36947964 DOI: 10.1016/j.bbrc.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023]
Abstract
The widespread adoption of chimeric antigen receptor (CAR)-T cell therapy has been hindered by its complex and costly manufacturing process. Induced pluripotent stem cells (iPSCs) have shown promise as a cellular immunotherapy alternative, due to their unlimited self-renewal potential in culture and capacity to differentiate into functional immune cell types. However, it is imperative to carefully select the original cell for iPSC seed preparation, as iPSCs have been found to retain the epigenetic imprint of the original somatic cells. Additionally, the efficiency of reprogramming terminal differentiated cells for immunotherapy must be addressed. Our research highlights the superiority of lymphocyte-origin cells over embryonic stem cells in functional immune cell differentiation. Furthermore, blocking Fas-FasL induced apoptosis in T cells significantly improves iPSC generation. Interestingly, transient Fas suppression in T cells does not alter the expression of Fas in the resulting iPSCs or affect their differentiation potential. This finding brings up new avenues in the field of cellular immunotherapy and provides a solution for creating high-quality and suitable iPSCs for lymphocyte differentiation for immunotherapy purposes.
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Affiliation(s)
- Jiangtao Ren
- Department of Oncology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou Medical University, Guangzhou, 510530, China; Nanjing Bioheng Biotech Co., Ltd, Nanjing, Jiangsu, China
| | - Xuhua Zhang
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Zhenhui Zhang
- Department of Oncology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou Medical University, Guangzhou, 510530, China; Anshun People's Hospital, Anshun, 561000, China
| | - Jiafeng Pan
- Department of Oncology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou Medical University, Guangzhou, 510530, China; Anshun People's Hospital, Anshun, 561000, China
| | - Zhexue Hao
- Department of Oncology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou Medical University, Guangzhou, 510530, China; Anshun People's Hospital, Anshun, 561000, China
| | - Jin Li
- Department of Oncology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou Medical University, Guangzhou, 510530, China; Anshun People's Hospital, Anshun, 561000, China.
| | - Jun Liu
- Department of Oncology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou Medical University, Guangzhou, 510530, China.
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Qin M, Chen H, Zhang L, Zhong Y. Report of a rare retroperitoneal teratoid Wilms' tumor. Asian J Surg 2023:S1015-9584(23)00178-1. [PMID: 36878799 DOI: 10.1016/j.asjsur.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 02/03/2023] [Indexed: 03/07/2023] Open
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Antonelli L, Ardizzone D, Ravi P, Bagrodia A, Mego M, Daneshmand S, Nicolai N, Nazzani S, Giannatempo P, Franza A, Heidenreich A, Paffenholz P, Saoud R, Eggener S, Ho M, Oswald N, Olson K, Tryakin A, Fedyanin M, Naoun N, Javaud C, Fizazi K, King JM, Adra N, Douglawi A, Cary C, Sweeney C, Fankhauser CD. Risk of residual cancer after complete response following first-line chemotherapy in men with metastatic non-seminomatous germ cell tumour and International Germ Cell Cancer Cooperative Group intermediate/poor prognosis: A multi-institutional retrospective cohort study. Eur J Cancer 2023; 182:144-154. [PMID: 36787661 DOI: 10.1016/j.ejca.2022.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/18/2022] [Accepted: 12/23/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Current guidelines recommend surveillance in metastatic non-seminomatous germ cell tumour patients treated with first-line-chemotherapy and a complete clinical response (normalisation of serum tumour markers and residual masses <1 cm). However, this recommendation is based on a series including patients with good prognosis according to International Germ Cell Cancer Cooperative Group prognostic group (IGCCCG-PG). The aim of this study was to analyse the proportion of residual teratoma and survival among patients with intermediate/poor IGCCCG-PG and a complete clinical response after first-line-chemotherapy. MATERIAL & METHODS This is a retrospective study of men with intermediate/poor IGCCCG-PG, who had a complete clinical response after first-line chemotherapy. Patients were either followed by surveillance or treated with post-chemotherapy retroperitoneal lymph node dissection (pcRPLND). RESULTS Between 2009 and 2018, 143 men with intermediate (n = 83) or poor (n = 60) IGCCCG-PG were treated at 11 international centres. Among 33 patients treated with pcRPLND, the specimen showed teratoma and viable cancer in 16 (48%) and 4 (12%). During a median a 7-year follow-up, 20/110 (18%) patients managed with surveillance relapsed, of whom seven (6%) had a retroperitoneal-only relapse versus 2/33 patients managed with pcRPLND relapsed. No difference was observed regarding overall survival (OS) among men treated with pcRPLND or surveillance (5-year OS, 93% and 89%, p-value = 0.35). The median time-to-recurrence among men on surveillance was 1.3 years (range: 0.3-9.1), and the most common sites of relapses included retroperitoneum (11%), chest (5%), and bones (4%). CONCLUSIONS While most men with intermediate/poor IGCCCG-PG harbour teratoma/cancer in the retroperitoneum despite a complete response to first-line-chemotherapy, only 6% managed with surveillance relapsed in the retroperitoneum. There was no significant difference in OS between the two groups.
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Affiliation(s)
- Luca Antonelli
- Department of Urology, Luzerner Kantonsspital, University of Lucerne, Switzerland; Department of Urology, Policlinico Umberto I, Rome, Italy
| | | | - Praful Ravi
- Department of Medicine, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Aditya Bagrodia
- Department of Urology, The University of Texas Southwestern, Dallas, TX, USA
| | - Michal Mego
- Department of Oncology, Comenius University, National Cancer Institute, Bratislava, Slovak Republic
| | - Siamak Daneshmand
- Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nicola Nicolai
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sebastiano Nazzani
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Patrizia Giannatempo
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Franza
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany; Department of Urology, Medical University, Vienna, Austria
| | - Pia Paffenholz
- Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
| | - Ragheed Saoud
- Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - Scott Eggener
- Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | - Matthew Ho
- Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | | | | | - Alexey Tryakin
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Mikhail Fedyanin
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | | | | | - Karim Fizazi
- Institut Gustave Roussy, Villejuif Cedex, France
| | - Jennifer M King
- Division of Medical Oncology, Indiana University School of Medicine, Indianapolis, USA
| | - Nabil Adra
- Division of Medical Oncology, Indiana University School of Medicine, Indianapolis, USA
| | - Antoin Douglawi
- Division of Medical Oncology, Indiana University School of Medicine, Indianapolis, USA
| | - Clint Cary
- Division of Medical Oncology, Indiana University School of Medicine, Indianapolis, USA
| | - Christopher Sweeney
- Department of Medicine, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Christian D Fankhauser
- Department of Urology, Luzerner Kantonsspital, University of Lucerne, Switzerland; University of Zurich, Zurich, Switzerland.
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Abstract
The development of somatic-type malignancy (SM) in testicular germ cell tumor represents a major challenge in the diagnosis and treatment of testicular cancer. Most SMs are derived from teratoma, and the remainder is associated with yolk sac tumor. They occur more frequently in metastases than in primary testicular tumors. SMs demonstrate a variety of histologic types, including sarcoma, carcinoma, embryonic-type neuroectodermal tumor, nephroblastoma-like tumor, and hematologic malignancy. Sarcoma, particularly rhabdomyosarcoma, accounts for the majority of SMs in the primary testicular tumors, whereas carcinoma, particularly adenocarcinoma, is the most common SM in metastases. Although SMs derived from testicular germ cell tumors mimic their histologic counterparts in other organs with overlapping immunohistochemical profiles, isochromosome 12p is present in most SMs, which can be useful in the differential diagnosis. The presence of SM in the primary testicular tumor may not worsen the outcome, but the development of SM in metastasis is associated with a poor prognosis. Furthermore, somatic-type carcinoma is likely associated with a worse prognosis than somatic-type sarcoma. Although SMs respond poorly to the cisplatin-based chemotherapy, timely surgical resection is an effective treatment for most patients.
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Affiliation(s)
- Charles C Guo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77401, USA.
| | - Bogdan Czerniak
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77401, USA
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Smith LP, Brubaker LW, Wolsky RJ. It Does Exist! Diagnosis and Management of Thyroid Carcinomas Originating in Struma Ovarii. Surg Pathol Clin 2023; 16:75-86. [PMID: 36739168 DOI: 10.1016/j.path.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Thyroid carcinoma originating in struma ovarii comprises a small minority of all cases of struma ovarii. Given the rarity of this diagnosis, literature to guide evaluation and management is limited. The most common carcinoma originating from struma ovarii is papillary thyroid carcinoma. Treatment includes surgery, including a fertility sparing approach if disease is confined to the ovary, with consideration of total thyroidectomy and radioactive iodine ablation for high-risk pathologic features or disease spread beyond the ovary. This review discusses the histopathologic findings, molecular pathology, clinical implications and management, and prognosis of thyroid carcinomas originating in struma ovarii.
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Affiliation(s)
- Lynelle P Smith
- Department of Pathology, University of Colorado School of Medicine, 12605 East 16th Avenue, Mail Stop F768, Aurora, CO 80045, USA
| | - Lindsay W Brubaker
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Colorado School of Medicine, Academic Office 1 12631 East 17th Avenue, B198-6, Aurora, CO 80045, USA
| | - Rebecca J Wolsky
- Department of Pathology, University of Colorado School of Medicine, 12605 East 16th Avenue, Mail Stop F768, Aurora, CO 80045, USA.
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Zhou G, Sun F, Yu X, Huang R, Liu X, Ouyang Y, Yang Z, Li S. Clinical characteristics and long-term management of prepubertal testicular teratomas: a retrospective, multicenter study. Eur J Pediatr 2023; 182:1823-1828. [PMID: 36795187 PMCID: PMC10167136 DOI: 10.1007/s00431-023-04859-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
Prepubertal testicular teratomas are rare tumors with limited practical guidance for their management. This study aimed to analyze a large multicenter database to establish the optimal management of testicular teratomas. We retrospectively collected data on testicular teratomas in children younger than 12 years who underwent surgery without postoperative chemotherapy in three large professional children's institutions in China between 2007 and 2021. The biological behavior and long-term outcomes of testicular teratomas were analyzed. In total, 487 children (with 393 mature teratomas and 94 immature teratomas) were included. Among mature teratomas, 375 cases were testis-sparing, 18 were orchiectomies, 346 were operated through the scrotal approach, and 47 underwent the inguinal approach. The median follow-up period was 70 months, and no recurrence or testicular atrophy was observed. Among the children with immature teratomas, 54 underwent testis-sparing surgery, 40 underwent orchiectomy, 43 were operated through the scrotal approach, and 51 were operated through the inguinal approach. Two cases of immature teratomas with cryptorchidism had local recurrence or metastasis within 1 year of the operation. The median follow-up duration was 76 months. No other patients had recurrence, metastasis, or testicular atrophy. Conclusion: Testicular-sparing surgery is the first treatment choice for prepubertal testicular teratomas, with the scrotal approach being a safe and well-tolerated strategy for these diseases. Additionally, patients with immature teratomas and cryptorchidism may have tumor recurrence or metastasis after surgery. Therefore, these patients should be closely followed up in the first year after surgery. What is Known: • There is a fundamental difference between testicular tumours in childhood and those in adulthood - not only in terms of the difference and incidence but also in terms of histology. • For surgical techniques, the inguinal approach is recommended for the treatment of testicular teratomas in children. What is New: • The scrotal approach being a safe and well-tolerated strategy for testicular teratomas in children. • Patients with immature teratomas and cryptorchidism may have tumor recurrence or metastasis after surgery. These patients should be closely followed up in the first year after surgery.
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Affiliation(s)
- Guanglun Zhou
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Fenglan Sun
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, China
| | - Xin Yu
- Department of Urology, Anhui Provincial Children's Hospital, Hefei, China
| | - Ruifeng Huang
- Department of Gastroenterology and Zhengzhou Key Laboratory of Children's Digestive Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Xiaodong Liu
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Yaoling Ouyang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, China
| | - Zhilin Yang
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Shoulin Li
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China.
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