Encefalitis por anticuerpos contra el receptor N-metil-D-aspartato secundaria a teratoma ovárico en una paciente pediátrica / Encephalitis due to antibodies against the N-methyl-D-aspartate receptor secondary to ovarian teratoma in a pediatric patient

La encefalitis por anticuerpos contra el receptor N-metilD-aspartato es un proceso inmunomediado en el que autoanticuerpos se dirigen contra la subunidad GluN1 del receptor de glutamato del sistema nervioso central. Se caracteriza por la aparición aguda o subaguda de síntomas psiquiátricos, como confusión, pérdida de la memoria a corto plazo, cambios de conducta, catatonía, seguidos por manifestaciones neurológicas, tales como convulsiones, alteraciones del movimiento, disfunciones autonómicas, coma y depresión respiratoria. Es grave y potencialmente mortal. Su asociación con teratoma de ovario como síndrome paraneoplásico fue descrita en mujeres jóvenes. En la población pediátrica, es mucho menos frecuente y se reporta en comunicaciones de 1 o 2 pacientes y en series de pocos casos. Se presenta una paciente de 13 años con encefalitis paraneoplásica por anticuerpos contra el receptor N-metil-Daspartato, secundaria a un teratoma ovárico maduro.

The encephalitis due to antibodies against the N-methylD-aspartate receptor is a process immune-mediated in which antibodies are directed against the GluN1 subunit of the glutamate receptor in the central nervous system. It is characterized by an acute or subacute onset of psychiatric symptoms such as confusion, short-term memory loss, behavioral changes, catatonia followed by neurological manifestations such as seizures, movement disturbances, autonomic dysfunctions, coma, and respiratory depression. It is serious and life threatening. Its association with ovarian teratoma as a paraneoplastic syndrome was described in youngwomen. In the pediatric population it is much less frequent and is reported in publications of one or two patients and in series of few cases. We present a 13-year-old patient with encephalitis paraneoplastic due to antibodies against the N-methyl-Daspartate receptor, secondary to a mature ovarian teratoma.

Cistoadenoma volumoso associado a teratoma ovariano maduro, com evolução para pseudomixoma peritoneal: relato de caso / Giant cystadenoma associated with mature ovarian teratoma with progression to pseudomyxoma peritonei: a case report

Massas anexiais representam grande desafio diagnóstico, devido a seu caráter geralmente assintomático¹. Traz-se caso peculiar de paciente que evoluiu com sintomas exuberantes de rápida evolução, situação característica de cistoadenomas, tumores benignos de origem epitelial²,³. Realizada laparotomia, com achados macroscópicos que revelaram conteúdo mucinoso e presença de pelos e neovascularização em seu interior. O anatomopatológico confirmou o diagnóstico de cistoadenoma associado a teratoma ovariano, sendo assim considerado um tumor de colisão ovariana.

Adnexal masses represent a major diagnostic challenge due to its usually asymptomatic characteritcs¹. We present a peculiar case of a patient who evolved with exuberant symptoms of rapid evolution, characteristic of cystadenomas, benign tumors of epithelial origin²,³. Laparotomy was performed, with macroscopic findings that revealed mucinous content and the presence of hairs and neovascularization inside. Pathology confirmed the diagnosis of cystadenoma associated with ovarian teratoma, thus being considered an ovarian collision tumor.

Fetus in Fetu as a suprarenal mass in a neonate - a rare and perplexing entity

Fetus in fetu (FIF) is a rare entity in which a malformed vertebrate fetus is incorporated within its twin. This entity should be differentiated from a teratoma, which has more malignant potential. We describe a neonate with a heterogeneous calcified suprarenal mass. The aspiration cytology revealed a heterogeneous cell population with spindle cells and small round blue cells. Operative and histopathologic examination showed features consistent with a fetus in fetu. This case report describes a rare entity and discusses its clinical presentation, cytological features on fine-needle aspiration, and the difficulties posed in its differentiation from a teratoma.

Tumores cardíacos pediátricos: características de imagens ecocardiográficas / Pediatric cardiac tumors: echocardiographic imaging features

Tumores cardíacos (TC) em crianças são lesões muito raras, mas seu diagnóstico é fundamental para a conduta adotada para o paciente. A ecocardiografia é a modalidade de imagem cardiovascular mais utilizada na prática clínica para o diagnóstico inicial de TC em pacientes pediátricos. Conhecer as características ecocardiográficas das TCs pode possibilitar um diagnóstico cada vez mais precoce e a identificação de sua etiologia mais provável. Os TCs primários e benignos são os mais frequentes na população pediátrica. Entre os TCs benignos, os mais frequentes em fetos e neonatos são rabdomiomas e teratomas. Em crianças e adolescentes, rabdomiomas e fibromas são os mais comuns. Neste artigo, descrevemos as características ecocardiográficas dos principais TCs em idades pediátricas.(AU)

Cardiac tumors (CTs) in children are very rare, but their diagnosis is crucial for patient management. Echocardiography is the most commonly used cardiovascular imaging modality in clinical practice for the initial diagnosis of CTs in pediatric patients. Knowing the echocardiographic characteristics of CTs can enable an increasingly early diagnosis and the identification of its most likely etiology. Primary and benign CTs are the most frequent types in the pediatric population. Among benign CTs, the most frequent in fetuses and neonates are rhabdomyomas and teratomas. In children and adolescents, rhabdomyomas and fibromas are more common. Here we describe the echocardiographic characteristics of the most common CTs in pediatric patients.(AU)

Mature Solid Teratoma of the Retroperitoneum Presenting as Sigmoid Colon Polyp with Lower Gastrointestinal Bleeding: A Case Report

Mature colonic teratomas are rare tumors and no case, to the best of our knowledge, has been reported from the African continent. In addition, some pedunculated teratomas in the colon have been treated by endoscopic polypectomy and classified as primary teratoma of the colon. We report a case of a distinct intra sigmoid pedunculated teratoma originating from the retroperitoneum of a 4-year-old African girl and we highlight the potential for misclassification of primary origin of endoscopically removed polypoid teratomas in the colon. CASE PRESENTATION: A 4-year-old black African female child who presented with abdominal pain and hematochezia. On clinical assessment, she was found to be anaemic and to have a sigmoid colon mass. At surgery, there was a mobile mass within the lumen of sigmoid colon and the mass was fixed to the retroperitoneum by a stalk of tissue. Pathologist's review of the resected sigmoid segment showed a pedunculated intra-sigmoid mass with the stalk traversing the wall of the colon. The mass was histologically proven a mature solid teratoma. CONCLUSION: This, to the best of our knowledge, is the first report of intra sigmoid teratoma from the African continent. It highlights the potential for misclassification of endoscopically resected colonic teratomas

Clinical, sonographic and anatomopathological aspects of ovarian teratoma in a heifer / Aspectos clínicos, ultrassonográficos e anatomopatológicos do teratoma ovariano em uma novilha

Teratomas rarely occur in domestic species, especially in cattle. These tumors originate in fetal life and are characterized by rapid growth, which justifies their frequent detection in young animals. This study reported a case of ovarian teratoma in a heifer. On physical examination, the main signs identified were apathy, abdominal distention and tension, empty rumen, and mushy diarrhea. During rectal palpation, a mass was identified in the pelvic region, which was suggestive of cysts on ultrasound examination. The animal underwent laparotomy, followed by euthanasia due to a poor prognosis. At necropsy, a 54 x 43 x 52 cm (length x width x thickness) tumor was observed in the right ovary with multiple cystic areas, in addition to masses associated with multiple adhesions of the intestinal loops and peritonitis. On histopathology, muscle, cartilage, bone, nervous and epithelial tissue, glands, hair with follicles, were identified in the affected ovary. There was mixed inflammation and foci of necrosis observed with a complete absence of ovarian architecture in both the ovaries. Infiltrations were identified in the lymph nodes and mesenteric vessels. Glandular ducts were seen from the serosa to the intestinal mucosa. A locally infiltrative and expansile ovarian teratoma was diagnosed accordingly. It is considered that this kind of tumor can induce abdominal distension and absence of estrus in previously healthy, non-pregnant heifers.

Os teratomas são tumores raros nas espécies domésticas, sobretudo em bovinos. Esses tumores são caracterizados por crescimento rápido e origem durante a vida fetal, o que justifica seu diagnóstico frequente em animais jovens. O presente trabalho relata um caso de teratoma ovariano em uma novilha. No exame físico, os principais sinais identificados foram apatia, distensão e tensão abdominal, rúmen vazio e diarreia pastosa. Durante a palpação retal, uma massa foi identificada na região pélvica. Ao exame ultrassonográfico, a massa era sugestiva de cistos. O animal foi submetido a laparotomia, seguido de eutanásia devido ao mau prognóstico. Na necropsia foi observado um tumor de 54 x 43 x 52 cm (comprimento x largura x espessura) no ovário direito com múltiplas áreas císticas, além de massas associadas à múltiplas aderências das alças intestinais e peritonite. Na histopatologia foram identificados no ovário acometido a presença de tecidos muscular, cartilaginoso, ósseo, nervoso e epitelial, com glândulas, pelos e folículos. Havia inflamação mista e focos de necrose com ausência completa de arquitetura ovariana em ambos os ovários. Infiltrações foram identificadas em linfonodos e vasos mesentéricos. Ductos glandulares foram vistos desde a serosa até mucosa intestinal. Diagnosticou-se um teratoma ovariano localmente infiltrativo e expansivo. Considera-se que este tumor pode induzir distensão abdominal e ausência de estro em novilhas previamente sadias e não gestantes.

Transformación maligna de un teratoma maduro de ovario durante la gestación / Malignant transformation of an ovarian mature teratoma during pregnancy

RESUMEN El riesgo de cáncer de ovario a lo largo de la vida de una mujer es menor de 2 %, y durante la vida reproductiva es de 0,01 %. La incidencia de cáncer de ovario durante el embarazo es de 1: 10 000 - 100 000 casos. La mayoría de las masas anexiales en la gestación son asintomáticas. El diagnóstico se realiza frecuentemente mediante un hallazgo casual en la ecografía obstétrica; se ha estimado una incidencia de 0,2 - 2 %, y de estas, 1 - 6 % son malignas. El carcinoma epidermoide desarrollado en un teratoma quístico maduro es una rara neoplasia que representa, aproximadamente, el 2 % de los tumores primarios del ovario. Se presenta una paciente con diagnóstico accidental de teratoma ovárico maduro con diferenciación de carcinoma epidermoide, durante la realización de una cesárea.

ABSTRACT The risk of ovarian cancer throughout a woman's life is less than 2%, and during reproductive life it is 0.01%. The incidence of ovarian cancer during pregnancy is 1: 10,000 - 100,000 cases. Most adnexal masses in pregnancy are asymptomatic. Diagnosis is frequently made by casual finding on obstetric ultrasound; an incidence of 0.2 - 2% has been estimated, and 1 - 6% of them are malignant. Squamous cell carcinoma developed in a mature cystic teratoma is a rare neoplasm that represents approximately 2% of primary ovarian tumors. We present a patient with an accidental diagnosis of mature ovarian teratoma with differentiation of squamous cell carcinoma, during a cesarean section.

Reporte de un caso fatal de encefalitis autoinmunitaria asociada a teratoma ovárico / Report of a fatal case of autoimmune encephalitis associated with an ovarian teratoma

INTRODUCCIÓN: El teratoma del ovario es el tumor de células germinales más frecuente. Entre sus complicaciones se describen algunos síndromes paraneoplásicos, como la encefalitis por anticuerpos contra el receptor N-metil-D-aspartato (NMDA). CASO CLÍNICO: Mujer de 22 años sin antecedentes de importancia que consulta por cuadro clínico de 4 días de evolución caracterizado por síntomas psiquiátricos y un episodio convulsivo. Se considera un cuadro de meningoencefalitis y se indica manejo antibiótico de amplio espectro y antiviral. Ante el deterioro se sospecha una encefalitis autoinmunitaria, se identifica un tumor anexial en los estudios imagenológicos compatible con teratoma y se confirma el diagnóstico con el hallazgo de anticuerpos NMDA en el líquido cefalorraquídeo. A pesar de su resección y manejo sistémico, fallece a los 5 meses. DISCUSIÓN: La encefalitis autoinmunitaria asociada a un teratoma es inusual, pero es una complicación que debe sospecharse como diagnóstico de exclusión. La mayoría tienen un pronóstico favorable, aunque hasta una cuarta parte de los casos puede asociarse a daño irreversible en la corteza del hipocampo e incluso la muerte, principalmente cuando el diagnóstico y el tratamiento son tardíos. CONCLUSIONES: Este caso es un reto clínico que representa un vacío en la evidencia actual, puesto que no existe un estándar de manejo de los teratomas. Se propone que, una vez diagnosticado un teratoma, se realice una cistectomía ovárica. Son necesarios más estudios para validar esta recomendación.

INTRODUCTION: The ovarian teratoma is the most common cell germ tumor. Some paraneoplastic syndromes have been described, including the anti-N-methyl-D-aspartate (NMDA) receptor encephalitis as part of its complications. CASE REPORT: A 22 years old female patient with no important medical history, consults due to an acute psychotic disorder and a convulsion. A meningoencephalitis was considered and broad-spectrum antibiotics and antivirals were started. Faced with deterioration, an autoimmune encephalitis is considered as well. Imaging studies revealed an ovarian teratoma and diagnosis was confirmed with antibodies against NMDA receptor in cerebrospinal fluid. Despite its resection and systemic management, the patient dies after 5 months. DISCUSSION: The autoimmune encephalitis associated with an ovarian teratoma is rare, its a complication that must be suspected as an exclusion diagnosis and most have a favorable prognosis, however up to a quarter of cases can be associated with irreversible damage to the hippocampal cortex and even death, mainly when late diagnosis and treatment are made. CONCLUSIONS: This case is a clinical challenge, no evidence is available since there is no standard for teratoma management. It is proposed that once a teratoma is diagnosed, an ovarian cystectomy is performed. Further studies are necessary to validate this recommendation.

Teratoma oral: la importancia del diagnóstico prenatal y el trabajo interdisciplinario: un caso clínico / Epignathus, the importance of prenatal diagnosis and interdisciplinary work: A case report

Gracias al avance de la tecnología, es posible realizar el diagnóstico prenatal de distintas malformaciones congénitas que ponen en riesgo la vida del recién nacido. Entre estas, el teratoma oral o epignathus es una forma poco frecuente de teratoma congénito entre los que se localizan en cabeza y cuello. Suelen ser benignos y abarcan el 4 % de los teratomas neonatales.A partir del desarrollo de la técnica de tratamiento intraparto extraútero (EXIT, por su sigla en inglés), que se implementó en los años 90 para mantener la circulación fetal hasta asegurar la vía aérea del recién nacido, se logra planificar una estrategia de manejo multidisciplinario que permite el abordaje correcto de estas patologías. Se presenta un caso de teratoma oral gigante en una paciente de sexo femenino de 35 semanas de gestación, en quien se aplicó la técnica EXIT, y su evolución posterior.

Thanks to technological advances, it has been possible to carry out the prenatal diagnosis of different life-threatening congenital malformations. Among these, oral teratoma, or epignathus, is a rare form of congenital teratoma within those located in the head and neck. They are generally benign and comprise 4 % of neonatal teratomas. From the development of the EXIT technique (ex utero intrapartum treatment), which has been implemented since the 90's to support fetal circulation until the newborn's airway is secured, it is possible to plan a multidisciplinary management strategy that enables the correct approach of these pathologies.We present a case of giant epignathus in a 35-week gestation female patient, whose airway was secured using the EXIT technique, and follow up.

Squamous metaplasia of the rete ovarii do not suppress ovarian cyclicity and pregnancy in cattle: case report / [Metaplasia escamosa da rete ovarii não interrompe a ciclicidade ovariana e a gestação em bovinos: relato de caso]

Squamous metaplasia of the rete ovarii is an ovarian pathologic change characterized by replacement of the normal single layered cuboidal epithelium of the rete ovarii by a stratified squamous keratinized epithelium. Uterus and ovaries from a local slaughterhouse pregnant crossbreed cow were evaluated through ultrasound, macroscopically and histologically. Grossly, there were multiple cysts in both ovaries, which were histologically characterized as rete ovarii cysts with squamous metaplasia and intraluminal accumulation of keratinized material. Squamous metaplasia of the rete ovarii has been previously reported in cows, however this is the first report of this condition in a pregnant animal, demonstrating that this ovarian change is compatible with pregnancy.(AU)

A metaplasia escamosa da rete ovarii é uma patologia ovariana caracterizada pela substituição do epitélio simples cuboidal normal da rete ovarii por um epitélio estratificado escamoso queratinizado. Útero e ovários de uma vaca mestiça gestante, proveniente de abatedouro, foram avaliados por ultrassonografia, macroscopia e histologia. Verificaram-se vários cistos em ambos os ovários, histologicamente caracterizados como cistos de rete ovarii com metaplasia escamosa, com acúmulo intraluminal de material queratinizado. Metaplasia escamosa da rete ovarii foi relatada anteriormente em vacas, porém este é o primeiro relato em que essa alteração ovariana é compatível com manutenção da ciclicidde ovariana e gestação na vaca.(AU)

Presentación inusual de teratomas ováricos bilaterales en gemelas / Bilateral ovarian mature teratomas in twins: an unsual presentation

RESUMEN Los teratomas maduros son los tumores ováricos más frecuentes en edad pediátrica. A la fecha, se han descrito escasos reportes sobre su aparición en gemelas. Se presenta el caso de teratomas ováricos bilaterales en gemelas bicoriales, tratadas con tumorectomía laparoscópica. A los 45 días post-operatorios, ambas presentan recurrencia bilateral con marcadores tumorales negativos. Se realiza una nueva tumorectomía laparoscópica, cuyo estudio histopatológico confirma teratomas maduros. Presentan segunda recurrencia evidenciada en control imagenológico a los 2 meses post-quirúrgicos. Se plantea la posible asociación genética y/o familiar en la aparición de teratomas ováricos, la cual, hasta el momento, es prácticamente desconocida.

ABSTRACT Mature cystic teratomas are the most frequent ovarian tumor in children. There are few reports describing mature teratoma in twins to date. We present a case of bicorial twins with bilateral ovaric mature cystic teratoma treated with laparoscopic tumorectomy. 45 days after surgery, both present bilateral recurrence with negative tumor markers. The patients underwent a new laparoscopic tumor resection, where histopathological diagnosis confirms mature teratomas. Ultrasound control describes second recurrence 2 months after surgery. There is a possible genetic and/or family association in the presentation of ovarian teratomas, which currently, is unknown.

Brain teratoma in a free-ranging mallard (Anas platyrhynchos) - case report / [Teratoma cerebral em um pato-real (Anas platyrhynchos) de vida livre - relato de caso]

Teratoma is a rare neoplasia with differentiation in two or three germ cell lines. Intracranial teratoma in birds has rarely been reported, especially affecting the brain. This is the first report of a brain teratoma in a mallard with neurological clinical signs. The neoplasm was characterized as a mature brain teratoma, extending from the cerebellum to the brainstem, and with one nodule in the cortex.(AU)

O teratoma é uma neoplasia rara, com diferenciação em duas ou três linhagens de células germinativas. Teratomas intracranianos, em aves, são raramente relatados, principalmente, com localização cerebral. Este é o primeiro relato de teratoma cerebral em um pato-real com sinais clínicos neurológicos. A neoplasia foi caracterizada como um teratoma cerebral maduro, estendendo do cerebelo ao tronco encefálico e com um nódulo no córtex.(AU)

Pure yolk sac tumor of sacrococcygeal region

The sacrococcygeal region is the most common site for the extragonadal germ cell tumors comprising seminomatous and non-seminomatous tumors. Seminomatous tumors are seminomas, and non-seminomatous tumors comprise mainly teratoma (mature and immature), yolk sac tumor (YST), embryonal carcinoma (EC), and choriocarcinoma. These tumors occur in newborns, infants, and adolescents. Other common sites for extragonadal germ cell tumors are the brain and mediastinum, although they may occur anywhere in the body. These tumors may occur in mixed as well as pure form. So, sectioning from different areas should be done before labeling them as pure germ cell tumors. YST, in its pure form, is rare and therefore should not be missed as it is chemosensitive. The patient should be thoroughly assessed clinically. Imaging also becomes necessary while evaluating swelling in the sacrococcygeal region and can aid in differentials. When the clinical and imaging suspicion of either Sacrococcygeal teratoma or other germ cell tumor is high, serum biomarkers as alfa-fetoprotein should be requested. The serum levels are necessary and should be done preoperatively, postoperatively, and during the course of chemotherapy as follow-up. However, the final diagnosis rests on the histopathological diagnosis. We report one such case of pure YST in the sacrococcygeal region in a 9-month-old female child. The imaging suggested sacrococcygeal teratoma type 4, and high alfa-fetoprotein levels were determined postoperatively.

Epignathus with oropharynx destruction

Epignathus, is a rare oropharyngeal teratoma arising from the head and neck region. Sporadic cases have been described with associated intracerebral teratoma. Even more infrequent and extraordinary is the circumstance of a teratoma with oropharynx destruction. We describe the case of a fetus with pharyngeal mass that completely destroyed the oral cavity. The histological examination revealed an immature teratoma (G3); only one other G3 case has been described.

A rare combination of Dermoid cyst and Cystadenoma: Are collision tumors in the ovary a real entity?

Collision tumors have been reported in various organs like the gastrointestinal tract, lung, skin, adrenals, central nervous system, lymph nodes, uterus, but are rarely seen in the ovary. Collision tumors are two histologically distinct neoplasms in the same organ without any intermixture between them. Here we present a case of a collision tumor of the ovary represented by a mucinous cystadenoma and teratoma. It is imperative for a surgical pathologist to correctly diagnose the collision tumor components and differentiate them from mixed tumors as it will dictate the appropriate treatment based on the individual biological aggressiveness of each component.

Clinical analysis of 40 newborns with head and neck occupying lesions / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinical features, diagnoses and treatments of head and neck occupying lesions in newborns. Methods: All newborns with head and neck occupying lesions admitted to Neonatel Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University form January 2014 to November 2019 were included. There were 23 males and 17 females, admission age was from 2 d-28 d, and the clinical manifestations, examinations, treatments and outcomes were evaluated. Results: Among 40 newborns with head and neck occupying lesions, 22 cases were admitted with dyspnea, 15 cases with masses in oral cavity or head and neck, 2 cases with fever as the first symptom, and 1 case with hoarseness as the first symptom. There were 5 cases with local infection. All cases were examined with local ultrasound and CT or MRI. Nine cases with severe dyspnea were treated with invasive ventilationm, of them 6 cases underwent invasive ventilation for more than 48 hours, 4 cases received tracheal intubation and artificial nose. Diagnostic punctures were performed in 2 cases. Seven cases received conservative treatments. Surgeries were performed in 31 cases, and 25 cases obtained pathologic diagnoses, including 3 cases of soft palate mature teratomas, 1 case of hard palate teratoma, 1 case of granulosa cell tumor, 1 case of lobulated spindle cell tumor in tongue base, 1 case of polyp in right glottis, 1 case of polyp at esophageal entrance, 4 cases of lingual root cysts, 1 case of laryngeal cyst, 2 cases of thyroglossal duct cysts, 2 cases of lymphangiomas, 1 case of lymphangioma with hibernoma, 1 case of tracheal cyst, 1 case of esophageal cyst, 3 cases of left neck abscesses, 1 case of occipital hemangioma, and 1 case of left temporoparietal abscess. Conclusions: The head and neck occupying lesions in the newborn is prone to upper airway obstruction. Imaging examination can assist the diagnosis. Different treatments can be selected according to the natures of occupying lesions.

Teratomas del mediastino / Mediastinum Teratomas

RESUMEN Introducción: Los teratomas se definen como tumores de tejidos extraños al órgano o sitio anatómico en el cual se originan. Los teratomas mediastinales no son frecuentes, representan alrededor del 5 por ciento al 10 por ciento de todos los tumores mediastinales. Objetivo: Describir los resultados del tratamiento quirúrgico de pacientes con diagnóstico de teratomas mediastinales. Métodos: Se estudiaron 12 pacientes tratados entre enero de 2001 y diciembre de 2018. Las variables evaluadas fueron sexo, edad, tipo histológico: maduro o inmaduro, vía de acceso quirúrgico, accidentes quirúrgicos y evolución postoperatoria. Resultados: Correspondieron 9 al sexo femenino y 3 al masculino. El promedio de edad fue de 33,3 años (17-60 años). Hubo predominio absoluto del tipo maduro (11). La esternotomía media fue el acceso más frecuente. La toracotomía se realizó cuando el tumor, voluminoso, ocupaba la mayor parte de un hemitórax. Los accidentes quirúrgicos fueron un desgarro pulmonar y una apertura del pericardio. De dos pacientes tratados mediante cirugía torácica videoasistida, uno fue convertido por sangrado venoso molesto. Al año de seguimiento todos estaban vivos, sin evidencias de recidiva. Conclusiones: Contrariamente a lo esperado, hay predominio del sexo femenino, mientras que la edad y el tipo histológico coinciden con la literatura. La esternotomía, aún hoy, es comúnmente aceptada, a pesar del auge de la cirugía torácica videoasistida. La resección total produce resultados excelentes para los teratomas benignos(AU)

ABSTRACT Introduction: Teratomas are defined as tumors of tissues foreign to the organ or anatomical site in which they originate. Mediastinal teratomas are rare, accounting for about 5-10 percent of all mediastinal tumors. Objective: To describe the outcomes of the surgical treatment of patients diagnosed with mediastinal teratomas. Methods: Twelve patients treated between January 2001 and December 2018 were studied. The variables evaluated were sex, age, histological type (mature or immature), surgical access route, surgical accidents, and postoperative evolution. Results: Nine patients corresponded to the female sex and three, to the male. The average age was 33.3 years (17-60 years). There was an absolute predominance of the mature type (11). Median sternotomy was the most frequent access. Thoracotomy was performed when the bulky tumor occupied most of a hemithorax. The surgical accidents were lung tear and opening of the pericardium. Of two patients treated by video-assisted thoracic surgery, one was converted for bothersome venous bleeding. At one year of follow-up, all were alive, with no evidence of recurrence. Conclusions: Contrary to expectations, there is predominance of the female sex, while age and histological type coincide with the literature. Sternotomy, even today, is commonly accepted, despite the rise of video-assisted thoracic surgery. Total resection produces excellent outcomes in benign teratomas(AU)

Extragonadal malignant teratoma in a dog - case report / Teratoma extragonodal maligno em cão - relato de caso

Teratomas are neoplasms thought to arise from germ cells which usually occur within gonads and are rarely described on extragonadal sites. The present study reports a case of a 15 year old female mongrel dog with a lumbosacral tumor. The tumor was microscopically composed of embryonic tissues with areas containing atypical undifferentiated cells, leading to the diagnosis of a malignant teratoma. Malignant teratomas are uncommon tumors in domestic animals.(AU)

Os teratomas são neoplasias originárias das células germinativas que têm como sítio principal as gônadas; raramente ocorrem em sítios extragonodais. O presente estudo relata um caso de uma cadela de 15 anos de idade, sem raça definida, apresentando aumento de volume na região lombossacral que ao exame microscópico revelou neoformação composta por tecidos de origem embrionária, com áreas indiferenciadas exibindo atipia celular, características compatíveis com teratoma maligno. Teratomas malignos são incomuns em animais domésticos.(AU)