RESUMO
The patient was a 9-month-old girl who presented with an abdominal mass. Computed tomography scan revealed that the huge heterogeneous mass with cystic, calcified, and solid components occupied the upper abdomen, and diagnosis of teratoma was made preoperatively. At the operation, a tumor arising from gallbladder and gliomatosis peritonei with intact ovaries were found. This is a rare case report of teratoma that originated in the gallbladder associated with gliomatosis peritonei.
Assuntos
Neoplasias da Vesícula Biliar/cirurgia , Glioma/secundário , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Peritoneais/secundário , Teratoma/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Calcinose/etiologia , Diferenciação Celular , Colecistectomia , Terapia Combinada , Ciclofosfamida/administração & dosagem , Dactinomicina/administração & dosagem , Feminino , Neoplasias da Vesícula Biliar/tratamento farmacológico , Neoplasias da Vesícula Biliar/patologia , Glioma/tratamento farmacológico , Humanos , Lactente , Laparotomia , Omento/patologia , Neoplasias Peritoneais/tratamento farmacológico , Indução de Remissão , Teratoma/tratamento farmacológico , Teratoma/patologia , Vincristina/administração & dosagemRESUMO
Organ preservation is one of the requirements for maintaining the high quality of life after the treatment of malignant solid tumors in children. We analyze our recent results of renal preservation in the abdominal neuroblastoma and describe 3 cases of successful organ preservation in pelvic malignancy. Between 1982 and 1996, 29 patients with adrenal or retroperitoneal neuroblastoma, that extended into the surrounding tissues and organs and/or to the contralateral side, underwent delayed primary excision. Before 1982, 9 patients were treated and only one ipsilateral kidney was preserved. On the other hand, 13 of 20 kidneys were preserved after 1987. Adoption of cis-platinum deepened our awareness of preserving the kidney. Furthermore, we have altered our strategy since 1987 to continuing preoperative chemotherapy until the size of the tumor becomes as small as it is estimated completely resectable by our own index, which is derived from computed tomography. Kidneys are shielded during intraoperative irradiation, and the tumor relapsed from the shielded area of retroperitoneum in one patient. Four of 14 preserved kidneys became atrophic and lost their function. The bladder and the rectum were left intact at tumor resection after intensive chemotherapy in two patients with pelvic (one retroperitoneal and one vaginal) rhabdomyosarcoma. A yolk sac tumor of the vagina responded completely to chemotherapy with cis-platinum, etoposide and bleomycin. The patient has survived 7.5 years without any local and distant relapse in spite of the fact that surgery, aside from several diagnostic biopsies, was not undertaken.