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2.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(4): 153-160, oct.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-197643

RESUMO

Los embarazos cursan simultáneamente con una masa anexial de forma inusual; y cuando lo hacen, son en su mayoría de manera asintomática. En casi el 25% identificaremos un teratoma quístico maduro. Tanto el diagnóstico, como el seguimiento y tratamiento de dichas tumoraciones pueden dificultarse en esta etapa y la valoración de los pros y contras para optar por un tratamiento quirúrgico durante la gestación suponen un dilema importante. Entre las características a valorar está el tamaño de la tumoración. Cuando dichas masas son mayores de 10 cm, a pesar de tener características ecográficas benignas, pueden estar enmascarando una neoplasia en uno de cada 10 casos; lo que haría considerar el tratamiento quirúrgico durante la gestación; y en estas ocasiones se opta con frecuencia por realizar un abordaje laparotómico para evitar, en la medida de lo posible, la rotura de dichas tumoraciones gigantes. Presentamos el caso de una paciente gestante asintomática a la que se le diagnostica un quiste anexial gigante. Tras su estudio, se realiza una laparotomía exploradora en semana 16 de embarazo completando la anexectomía unilateral, con el diagnóstico definitivo de un teratoma quístico maduro. La recuperación posterior y la finalización a término de una gestación normoevolutiva se completa con éxito. Se hace una revisión del diagnóstico, seguimiento y abordaje quirúrgico de las masas anexiales encontradas durante la gestación


It is rare for pregnancies to occur simultaneously with an adnexal mass, and when they do, they are mostly asymptomatic. In almost 25%, it is identified as a mature cystic teratoma. Both the diagnosis, monitoring, and treatment of these diseases can be difficult at this stage, and the assessment of the pros and cons for surgical treatment during pregnancy, which can lead to controversy, is a major problem. Among the characteristics to be assessed is the size of the tumour. When these masses are larger than 10 cm, despite having benign ultrasound characteristics, they may be masking a neoplasm in 1 out of 10 cases. In which case, surgical treatment would be considered during the pregnancy and a laparoscopy approach is often carried out to avoid, as far as possible, the rupture of these giant tumour masses. The case is presented of an asymptomatic pregnant patient who is diagnosed with an adnexal giant cyst. After the work-up study, an exploratory laparotomy was performed in the 16th week of pregnancy, with a unilateral adnexectomy being performed, with the definitive diagnosis of a mature cystic teratoma. The subsequent recovery and the conclusion to full-term using standardised management was completed successfully. A review is presented on the diagnosis, follow-up and surgical approach of adnexal masses during pregnancy


Assuntos
Humanos , Feminino , Gravidez , Adulto , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Laparotomia/instrumentação , Neoplasias Ovarianas/cirurgia , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Parto Obstétrico , Cisto Dermoide/cirurgia , Ovariectomia/métodos , Neoplasias Ovarianas/patologia , Diagnóstico Diferencial , Biomarcadores Tumorais
3.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318239

RESUMO

Gastric teratoma is a rare entity beyond infancy and usually presents as a slow-growing asymptomatic abdominal mass. There are a few published reports of these tumours seen in patients beyond the age of 1 year. In resource-constrained population, these masses are usually neglected because of minimal symptoms associated with these tumours. We report a case of a 14-year-old adolescent who was diagnosed to have a large primary gastric teratoma and underwent en bloc excision with wedge resection of the stomach. A systematic review to identify the previously reported cases of primary gastric teratoma in patients of over the age of 1 year in last 50 years yielded only five articles. A high index of suspicion for primary gastric teratomas in young children and adolescents presenting with asymptomatic large abdominal masses would help treat these patients with a curative intent and excellent treatment outcomes.


Assuntos
Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Teratoma/diagnóstico , Teratoma/cirurgia , Adolescente , Biópsia , Endoscopia Gastrointestinal , Humanos , Masculino , Neoplasias Gástricas/patologia , Teratoma/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
4.
J Laryngol Otol ; 134(7): 650-653, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32605677

RESUMO

BACKGROUND: Ex utero intrapartum treatment ('EXIT' procedure) is a well described method for maintaining maternal-fetal circulation in the setting of airway obstruction from compressive neck masses. When ex utero intrapartum treatment to airway is not feasible, ex utero intrapartum treatment to extracorporeal membrane oxygenation ('ECMO') has been described in fetal cardiopulmonary abnormalities. OBJECTIVE: This paper presents the case of a massively compressive midline neck teratoma managed with ex utero intrapartum treatment to extracorporeal membrane oxygenation, allowing for neonatal survival, with controlled airway management and subsequent resection. CASE REPORT: A 34-year-old-female presented with a fetal magnetic resonance imaging scan demonstrating a 15 cm compressive midline neck teratoma. Concern for failure of ex utero intrapartum treatment to airway was high. The addition of the ex utero intrapartum treatment to extracorporeal membrane oxygenation procedure provided time for the planned subsequent resection of the mass and tracheostomy. CONCLUSION: Ex utero intrapartum treatment procedures allow for securement of the difficult neonatal airway, while maintaining a supply of oxygenated blood to the newborn. Ex utero intrapartum treatment circulation lasts on average less than 30 minutes. The arrival of extracorporeal membrane oxygenation has enabled the survival of neonates with disease processes previously incompatible with life.


Assuntos
Cesárea/métodos , Oxigenação por Membrana Extracorpórea/métodos , Neoplasias de Cabeça e Pescoço/embriologia , Troca Materno-Fetal , Teratoma/embriologia , Adulto , Obstrução das Vias Respiratórias/embriologia , Obstrução das Vias Respiratórias/etiologia , Feminino , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Gravidez , Teratoma/cirurgia , Teratoma/terapia
5.
Z Geburtshilfe Neonatol ; 224(4): 187-193, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32575128

RESUMO

Fetal intrapericardial teratomas are rare and benign cardiac tumors. By comprehensive literature retrieval of the pertinent articles published since 2000, 49 articles with 61 cases of intrapericadial teratomas were recruited into this study. The intrapericardial teratomas were found during pregnancy in 55 cases (fetal group), while the tumors were detected until neonatal period in 6 cases (neonatal group). In the fetal group, 15 cases were critical with fetal/neonatal respiratory distress or cardiac tamponade. Antenatal treatments including centesis, shunt placement, open fetal surgery and the ex utero intrapartum treatment were required in 24 (43.6%) fetal cases. Postnatal intubation was required in 19 cases with 18 of them having immediate intubation after birth. Postnatal tumor resection was performed in 41 (95.3%) cases. In neonatal group, 4 neonates had respiratory distress and/or cardiac tamponade. Neonatal intubation was required in 1 (16.7%) patient. Surgical tumor resection was performed in all 6 patients. A comparison between the fetal and neonatal groups revealed that the fetal group was associated with higher refractory effusions while the neonatal group had a higher incidence of respiratory distress. Although the all cause death rate was higher in the fetal group than in the neonatal (25.5 vs. 0%), but lack of a statistical significance. Antenatal treatments for fetal intrapericardial teratomas are feasible but carry higher risks in comparison to neonatal cases.


Assuntos
Tamponamento Cardíaco/etiologia , Neoplasias Cardíacas/cirurgia , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Teratoma/cirurgia , Feminino , Feto , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido , Triagem Neonatal , Pericárdio , Gravidez , Cuidado Pré-Natal , Teratoma/diagnóstico por imagem , Teratoma/patologia , Ultrassonografia Pré-Natal
6.
Arch Gynecol Obstet ; 302(2): 315-320, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32556515

RESUMO

BACKGROUND: Anti-NMDA receptor antibody (anti-NMDAr) encephalitis, although still a rare condition, is well known to neurologists as it is the leading cause of non-infectious acute encephalitis in young women. However, this is less well known to gynecologists, who may have a decisive role in etiological management. Indeed, in 30-60% of cases in women of childbearing age, it is associated with the presence of an ovarian teratoma, whose removal is crucial in the resolution of symptomatology. OBJECTIVES: Primary objective of our work was to present a review in a very schematic and practical way for gynecologists, about the data on anti-NMDAr encephalitis in terms of epidemiology, clinical symptomatology, treatment and prognosis. The second objective was to propose a decision tree for gynecologists to guide them, in collaboration with neurologists and anesthesiologists, after the diagnosis of NMDAr encephalitis associated with an ovarian mass. METHOD: We conducted an exhaustive review of existing data using PubMed and The Cochrane Library. Then, we illustrated this topic by presenting two typical cases from our experience. RESULTS: Anti-NMDA antibody encephalitis association with an ovarian teratoma is common, especially in women of reproductive age. Complementary examinations in search of an ovarian teratoma must therefore be systematic to envisage a possible surgical excision that may improve patient prognosis. CONCLUSION: Anti-NMDA antibody encephalitis should not be ignored by gynecologists whose role in management is central.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Anticorpos/líquido cefalorraquidiano , Neoplasias Ovarianas/complicações , Receptores de N-Metil-D-Aspartato/imunologia , Teratoma/complicações , Adulto , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Encefalite Antirreceptor de N-Metil-D-Aspartato/epidemiologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/terapia , Feminino , Humanos , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Exame Físico , Prognóstico , Reprodução , Teratoma/patologia , Teratoma/cirurgia , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32520448

RESUMO

The clamshell incision (also known as a transverse or crossbow transsternal incision) was the common approach to the heart in the early days of cardiac surgery and was occasionally also used to access mediastinal tumors or both lungs. However, with the introduction of the median sternotomy, the clamshell incision was virtually forgotten, except for cardiothoracic trauma and double lung transplant. However, in rare situations, such as in large space-occupying lesions in the mediastinum, surgeons will resort to the clamshell approach to achieve exposure and complete resection.  In this video tutorial, we demonstrate the operative steps for using the clamshell approach in one of those rare clinical scenarios. The resected mass was a giant mediastinal teratoma measuring 21 x 27 x 6 cm.


Assuntos
Neoplasias do Mediastino/cirurgia , Teratoma/cirurgia , Toracotomia/métodos , Feminino , Humanos , Adulto Jovem
8.
Medicine (Baltimore) ; 99(18): e20107, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358400

RESUMO

BACKGROUND: Intramedullary cervical spinal cord teratomas (ICTs) are extremely rare, and diagnosis and treatment are challenging. We conducted a systematic review of the literature on the diagnosis and treatment of ICT. METHOD: The presentation, imaging manifestations, diagnosis, management, surgery findings, prognosis and histology were reviewed following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. English-language studies and case reports published from inception to 2018 were retrieved. Data on presentation, imaging characteristics, diagnosis, management, surgery findings, outcomes, and histopathology were extracted. RESULTS: Ten articles involving 10 patients were selected. The lesions were located in the upper cervical vertebrae in 4 cases, whereas in the lower cervical vertebrae in the remaining 6 cases. In 5 cases, the lesions were located on the dorsal side of the spinal cord, and in the center of the spinal cord in the remaining 5 cases. Quadriparesis (60%), paraplegia (30%), monoplegia (10%), and neck pain (50%) were the main presentations. The lesion appeared as a intramedullary heterogeneous signal during an MRI scan, and the lesion signal would be partially enhanced after the contrast medium was applied. All patients underwent surgical intervention through a posterior approach. Neurological function improved postoperatively in all patients. Two patients with pathology confirmed to be immature teratomas experienced recurrence. CONCLUSION: ICTs are extremely rare entities that are mainly located in the center or dorsal part of the spinal cord which mainly manifest as quadriplegia and neck pain. MRI is a useful modality that provides diagnostic clues. Surgery from a posterior approach is the primary treatment, and the effect of adjuvant therapy remains uncertain. The prognosis is mainly related to the pathological nature of the tumor and not the method of resection.


Assuntos
Vértebras Cervicais/patologia , Neoplasias da Medula Espinal/patologia , Teratoma/patologia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Humanos , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/cirurgia , Teratoma/diagnóstico por imagem , Teratoma/cirurgia
9.
J Ayub Med Coll Abbottabad ; 32(1): 132-135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32468772

RESUMO

Paediatric thoracic tumours resection is one of the most difficult procedure for any anaesthetist. Paediatric population is different from adults in many aspects, as they have small thoracic volume and more compressible mass effect on their airway and vascular structures. we are reporting a case of a huge paediatric thoracic tumour resection occupying the left thoracic cavity. The possible mechanism, consequences, prevention and management discussed in this report.


Assuntos
Neoplasias do Mediastino , Teratoma , Criança , Humanos , Masculino , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/cirurgia , Teratoma/diagnóstico , Teratoma/patologia , Teratoma/cirurgia , Tórax/diagnóstico por imagem , Tórax/patologia
10.
Health Qual Life Outcomes ; 18(1): 102, 2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32303229

RESUMO

AIM: The aims of this study were to evaluate health-related quality of life (HRQoL) in children with sacrococcygeal teratoma and to explore the effect of the scar on physical, emotional and behavioral aspects. METHODS: A cohort of children operated on for sacrococcygeal teratoma between 2000 and 2013 at Lund University Hospital, Sweden, and their parents were interviewed. HRQoL was evaluated with PedsQL, and scar satisfaction was estimated through Patient Observer Scar Assessment Score (POSA). RESULTS: All eligible children (n = 17) were included (100% response rate). Median age was 7.3 years (range 3.5-16.0). Mean total PedsQL score was 92.3 (range 72.0 to 99.0). Patients with comorbidity scored lower (87.5) than those without (95.0) (p < 0.05). Pain during sitting down was reported by two (20%) patients, and itching was reported by another two patients (20%) aged > 8 years. No children reported that they avoided situations due to the scar, and most (80% of children and 90% of parents) reported absent or only mild negative emotions when considering the scar. CONCLUSION: Children with sacrococcygeal teratoma had a good overall HRQoL, but comorbidity reduced the outcome. A few children reported scar-related impact on physical, behavioral and emotional aspects.


Assuntos
Cicatriz/psicologia , Qualidade de Vida , Região Sacrococcígea/cirurgia , Teratoma/cirurgia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Satisfação do Paciente , Suécia
12.
Cir. pediátr ; 33(2): 95-98, abr. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-190849

RESUMO

El teratoma sacrococcígeo (TSC) es el tumor congénito de células germinales más frecuente. Los pacientes afectados tienen un mayor riesgo de complicaciones perinatales y muerte, siendo la hemorragia y la descompensación cardiaca las causas más comunes de mortalidad neonatal. Presentamos el caso de un recién nacido pretérmino de 35 semanas con un TSC de gran tamaño diagnosticado por ecografía en el segundo trimestre. La embolización selectiva preoperatoria de la arteria sacra media y la resección quirúrgica total postnatal se realizaron con una mínima pérdida de sangre. El paciente fue dado de alta a los 25 días de vida con un examen físico normal. La embolización selectiva antes de la cirugía de resección del TSC gigante es factible y aparece como una técnica segura y útil en el control del sangrado perioperatorio


Sacrococcygeal teratoma (SCT) is the most frequent congenital germ cell tumor. Patients have a higher risk of perinatal complications and death, with bleeding and cardiac decompensation being the most common causes of neonatal mortality.This is the case of a 35-week preterm newborn with a large SCT diagnosed at ultrasound screening in the second trimester. Preoperative selective embolization of the middle sacral artery and total surgical resection were performed postnatally with minimal blood loss. The patient was discharged at 25 days of life with a normal physical examination. Selective embolization prior to giant SCT resection is feasible and appears as a safe and useful technique in the control of perioperative bleeding


Assuntos
Humanos , Masculino , Recém-Nascido , Teratoma/cirurgia , Região Sacrococcígea , Embolização Terapêutica , Cuidados Pré-Operatórios , Recém-Nascido Prematuro , Resultado do Tratamento
13.
J Craniofac Surg ; 31(3): e254-e256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32195831

RESUMO

Cervical teratoma is a rare tumor comprised of multiple tissue types. These masses can result in significant functional and aesthetic complications, and surgical intervention is the mainstay of treatment. The authors report the treatment and 8-year follow-up of a patient born with a massive cervicofacial teratoma. The mass was diagnosed in utero and required perinatal airway management. The patient underwent several procedures to enhance his appearance and function early on in life with an excellent outcome at intermediate follow-up.


Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Teratoma/cirurgia , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Recém-Nascido , Gravidez , Procedimentos Cirúrgicos Reconstrutivos , Teratoma/diagnóstico por imagem
15.
J Cardiothorac Surg ; 15(1): 35, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32051013

RESUMO

BACKGROUND: Mediastinal mature teratomas are rare tumors with diverse surgical approaches. The aim of this study is to review our experience of thoracoscopic surgery management in patients with teratomas. METHODS: We retrospectively reviewed 28 consecutive patients with mediastinal mature teratomas who underwent thoracoscopic surgery at Viet Duc University Hospital from January 2008 to August2018. Patients were divided into 2 groups with 2 types of thoracoscopic surgery, closed thoracoscopic surgery (CTS) group and video-assisted thoracoscopic surgery (VATS) group. The selection of sugical approach was based on sizes, locations and characteristics of tumors. Post-operative outcomes were assessed and compared between these 2 groups. RESULTS: There were 14 female and 14 male patients with a median age of 41.2 ± 13.8 years. A total of 22 teratomas were located on the right side of the chest cavity and 6 on the left side. We performed CTS in 21 patients (75%) and VATS in 7 patients (25%) for tumor resection. There were 3 cases (10.7%) required conversion to minithoracotomy (5 cm in incision length). Skin appendages accounted for the highest rate (96.4%) in pathology. There was no record of mortality or tumor recurrence detected by computerized tomography. CONCLUSION: A thoracoscopic surgery for a mediastinal mature teratoma was a feasible choice. Challenging factors such as large tumors, intraoperative bleeding and strong tumor cell adhesion were considered handling by conversion to mini-thoracotomy that could ensure safety procedures and complete removal of tumors. Extraction of tumor contents might be performed for patients with large mature cystic teratomas to facilitate thoracoscopic surgery.


Assuntos
Neoplasias do Mediastino/cirurgia , Teratoma/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Adolescente , Adulto , Criança , Conversão para Cirurgia Aberta , Feminino , Humanos , Masculino , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Teratoma/patologia , Toracotomia , Resultado do Tratamento , Carga Tumoral , Adulto Jovem
17.
Hinyokika Kiyo ; 66(1): 5-8, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-32028748

RESUMO

We report a case of retroperitoneal mature teratoma which was successfully treated by laparoscopic adrenalectomy. A 37-year-old woman complaining of right abdominal discomfort was referred to our hospital because computed tomography showed an adrenal tumor at another hospital. Magnetic resonance imaging showed a 10 cm adrenal tumor that consisted of fat with calcification. Endocrine examination showed no abnormal findings. Under the suspicion of myelolipoma, we performed laparoscopic right adrenalectomy. Histological diagnosis was mature teratoma. The patient had no recurrence at 5 years after surgery.


Assuntos
Neoplasias das Glândulas Suprarrenais , Laparoscopia , Mielolipoma , Teratoma , Adrenalectomia , Adulto , Feminino , Humanos , Recidiva Local de Neoplasia , Teratoma/cirurgia
18.
J Cardiothorac Surg ; 15(1): 36, 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066478

RESUMO

BACKGROUND: Mediastinal teratoma is a rare disease, many cases were reported before, but few articles focus on large case analyses. The objective of this article is to summarize the clinical characteristics of benign mediastinal teratoma and the experience of surgical treatment, especially thoracoscopic surgery for benign mediastinal teratoma. METHODS: The clinical data of 108 patients with benign mediastinal teratoma confirmed by operation and pathology from January 1992 to January 2018 were analyzed retrospectively. The clinical symptoms, imaging examination, surgical methods and prognosis of all patients were analyzed. We compared the difference of thoracoscopic surgery and thoracotomy surgery using 102 patients underwent only chest surgery. Normally distributed continuous variables were compared by independent sample t test. Categorical variables were analyzed by chi-square test. RESULTS: Imaging examination showed that all 108 cases of mediastinal teratoma were located in the anterior region of mediastinum. All cases underwent surgical resection, postoperative pathology confirmed that all cases were benign. 1 case was taken simple neck collar incision, 5 case was taken median thoracotomy combined with neck incision, other 102 cases were taken thoracoscopic surgery (22) or thoracotomy surgery (80). 4 cases were treated with partial pericardial resection due to adhesions, 12 cases underwent partial pericardial resection, 5 cases underwent lobectomy, 9 cases underwent wedge resection of lobe, and 2 patients underwent anonymous vein angioplasty. 1 case underwent second operation because of postoperative bleeding, 1 case of chylothorax, 1 case of recurrent laryngeal nerve injury, 2 cases of wound infection, 1 case of secondary pulmonary infection. 106 cases were followed up, period from 12 months to 10 years, no recurrence of tumor was found. Comparing to take thoracotomy surgery, patients underwent thoracoscopic surgery has strong advantage on intraoperative blood loss and hospital stay days after surgery (P < 0.05). tumor maximum diameter is larger for thoracotomy surgery group, as well as more patients suffer estimated adhesions from preoperative imaging. so we compared above parameters in patients with tumor diameter less than 10 cm with or without estimated adhesions from preoperative imaging, a strong advantage still can be found in thoracoscopic surgery group, inpatients with estimated adhesions from preoperative imaging, intraoperative blood loss (38.75 ± 15.53 vs 169.17 ± 208.82., P = 0.04) and hospital stay days after surgery (5.50 ± 0.93 vs 9.43 ± 6.54., P = 0.04) were better. In patients without estimated adhesions from preoperative imaging, intraoperative blood loss (46.67 ± 10.00 vs 110.53 ± 123.13., P = 0.06) and hospital stay days after surgery (4.70 ± 1.16 vs 7.53 ± 2.32., P = 0.01) were better. Especially, in thoracoscopic surgery group, hospital stay days after surgery was significantly shorter. CONCLUSION: The clinical manifestations and imaging performance of benign mediastinal teratoma were complicated, and the surgical treatment was effective. Compared with traditional thoracotomy surgery, thoracoscopic surgery can improve patients' quality of life, less intraoperative blood loss, and less hospital stay days after surgery, so if condition is permitted, thoracoscopic surgery should be a better choice.


Assuntos
Neoplasias do Mediastino/cirurgia , Teratoma/cirurgia , Toracoscopia , Toracotomia , Adulto , Perda Sanguínea Cirúrgica , Feminino , Humanos , Tempo de Internação , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Teratoma/diagnóstico por imagem , Teratoma/patologia , Toracoscopia/efeitos adversos , Toracotomia/efeitos adversos , Aderências Teciduais/complicações , Aderências Teciduais/cirurgia , Carga Tumoral
19.
Gynecol Oncol ; 157(1): 94-100, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31954532

RESUMO

OBJECTIVES: To evaluate the diagnostic, surgical, and oncological outcomes of patients with growing teratoma syndrome (GTS). METHODS: Patients diagnosed with ovarian immature teratoma (IMT) between 1980 and 2018 at Peking Union Medical College Hospital (PUMCH) were evaluated for the development of GTS. Their clinical characteristics, surgical and pathological data, and oncological outcomes were collected. RESULTS: Between 1980 and 2018, 175 cases of IMT were referred to PUMCH. Thirty-five patients subsequently developed GTS with a crude rate of approximately 20%. The median interval between the initial diagnosis of IMT and the first occurrence of GTS was 18.5 months (range, 6-78 months). Residual disease (P < 0.001) and gliomatosis peritonei (GP) at initial surgery (P = 0.023) were independent risk factors for GTS development. Fertility-sparing surgery for GTS was performed in 27 patients and four patients achieved five singleton pregnancies. The median follow-up time was 73 months (range, 11-401 months). Eleven patients developed at least one recurrence. Residual disease after GTS surgery was associated with GTS recurrence (P = 0.001). By the end of follow-up, 27 patients were alive without disease and the other eight patients were alive with disease. CONCLUSION: The presence of residual disease and GP at initial surgery are risk factors for GTS. Complete surgical resection is the cornerstone for treatment of GTS. The presence of residual disease after surgery for GTS is a risk factor for GTS recurrence. Fertility-sparing surgery should be performed because spontaneous pregnancy is possible. The overall prognosis of GTS is excellent.


Assuntos
Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/cirurgia , Teratoma/diagnóstico , Teratoma/cirurgia , Adolescente , Adulto , Criança , Feminino , Preservação da Fertilidade/métodos , Humanos , Estadiamento de Neoplasias , Neoplasia Residual/patologia , Tratamentos com Preservação do Órgão/métodos , Neoplasias Ovarianas/patologia , Prognóstico , Síndrome , Teratoma/patologia , Resultado do Tratamento , Adulto Jovem
20.
Interact Cardiovasc Thorac Surg ; 30(5): 788-789, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31985793

RESUMO

Mediastinal teratomas are uncommon, fast-growing thoracic tumours, which are usually diagnosed in childhood or adolescence. Neonatal forms are the rarest and often present with life-threatening respiratory distress syndrome. In our case, respiratory failure in a neonate was aggravated by severe cardiogenic shock due to aortic and systemic venous compression, extreme heart displacement and rotation, necessitating an emergency operation on the first day of life.


Assuntos
Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/cirurgia , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Choque Cardiogênico/etiologia , Teratoma/complicações , Teratoma/cirurgia , Fatores Etários , Aorta/patologia , Feminino , Humanos , Recém-Nascido , Neoplasias do Mediastino/diagnóstico , Teratoma/diagnóstico , Veias/patologia
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