胎儿巨大骶尾部畸胎瘤破裂后足月分娩1例

本文报告了1例妊娠14周经超声发现胎儿骶尾部畸胎瘤,超声联合MRI提示肿瘤分型为Ⅰ型。妊娠26周前肿瘤囊性部分占比>60%,妊娠28周肿瘤囊性部分自行破裂。妊娠期密切监测,妊娠36周 +5时,肿瘤体积增至12.8 cm×9.7 cm×12.3 cm。孕妇于妊娠37周行剖宫产术分娩。新生儿生后4 d于小儿外科...     

腹腔镜卵巢良性畸胎瘤手术40例体会

目的 :探讨应用腹腔镜行卵巢良性畸胎瘤手术的适应证与方式 ,预防和减少肿瘤破裂的发生。方法 :4 0例卵巢良性畸胎瘤患者行腹腔镜下囊肿剥除术。结果 :4 0例良性畸胎瘤手术均在腹腔镜下完成 ,无1例中转开腹 ,囊肿破裂 8例。平均手术时间 6 0min ,平均出血 80ml ,无术后出血、脏器损伤及化学性腹膜炎或肉芽肿的发生。结论 :应用腹腔镜行卵巢良性畸胎瘤的手术是完全可行的。     

等离子刀腹腔镜手术治疗卵巢良性病变252例临床分析

目的:探讨卵巢良性病变行等离子刀腹腔镜手术治疗的有效性及可行性。方法:回顾分析2006年10月至2009年10月为252例卵巢良性病变患者行腹腔镜手术的临床资料。结果:246例成功完成腹腔镜手术,成功率97.6%,手术时间30～120min,平均60min;术中出血10～60ml,平均18ml,住院3～5d。无并发症发生。结论:术者若具备熟练的腹腔镜操作技术,熟知器械性能,为卵巢良性病变患者行腹腔镜手术安全可行。     

Congenital hairy polyp of the soft palate

Hairy polyp is an unusual developmental malformation that is most frequently seen as a pedunculated tumor in the neonate. They are benign lesions containing elements of both ectodermal and mesodermal origin. The symptoms of hairy polyps relate both to their location and their size. Larger lesions produce symptoms due to feeding difficulties and airway obstruction while smaller lesions cause intermittent symptoms resulting from a ball-valve type of obstruction.We present two cases of a soft palate hairy polyp causing respiratory and feeding difficulties and review the literature.     

纵隔生殖细胞肿瘤的MSCT诊断

目的:分析纵隔生殖细胞肿瘤MSCT的表现,提高对本病的诊断水平。方法:共64例,采用GE Lightspeed 16层CT进行胸部平扫及增强扫描。结果:53例畸胎瘤,11例恶性生殖细胞瘤。53例畸胎瘤CT显示都含有脂肪,位于前纵膈。11例恶性生殖细胞瘤,肿瘤直径范围为7.0~28.0cm,均偏于纵隔一侧生长,位于中上前纵隔,平扫密度较低,CT值约20~30HU,增强扫描呈斑片状、边缘轻度强化;与周围大血管分界不清,肿瘤具有钻隙生长的趋势,肿瘤内部多发囊变。结论:CT对纵隔生殖细胞肿瘤,具有一定的诊断及鉴别诊断价值。     

Upper abdominal teratomas in infants: radiological findings and importance of the vascular anatomy

BACKGROUND: Primary upper abdominal teratomas are extremely rare tumours, most commonly arising in infants. The radiological literature relating to them is sparse. Surgical resection is difficult due to distortion of the vascular anatomy. OBJECTIVE: To reassess the value of preoperative imaging with specific reference to the presence/absence of typical features of teratoma, anatomical location and adjacent vascular anatomy. MATERIALS AND METHODS: The histopathology database was used to identify infants with upper abdominal teratoma. Pathological, surgical and radiological data were reviewed. RESULTS: The search of the database identified 12 infants (10 girls, 2 boys) with an abdominal/retroperitoneal teratoma during the period 1993 to 2006. All teratomas were benign. In the majority of infants, typical radiological features of teratoma were demonstrated (fat, calcium). Identification of the major abdominal vessels on CT scan (most commonly the inferior vena cava) was not possible in all infants. Distortion (and commonly encasement) of the adjacent major abdominal vessels was usually evident. CONCLUSION: Upper abdominal teratomas in infants have typical radiological features. Preoperative delineation of the major vascular anatomy is often imprecise. Significant distortion of vascular anatomy was present in all infants and awareness of this feature impacts on surgical planning.     

A Huge Intrapericardial Teratoma in an Infant

A case of huge intrapericardial teratoma diagnosed in a 9-month-old infant is presented. Echocardiography and thoracic computed tomography showed a voluminous multicystic intrapericardial mass with pericardial effusion. The tumor was resected surgically. Histopathological examination confirmed the diagnosis of immature teratoma.     

小儿腹膜后畸胎瘤29例诊治体会

目的总结腹膜后畸胎瘤的诊治体会。方法回顾性分析本院2000年5月至2012年3月收治的29例腹膜后畸胎瘤患儿的临床资料,分析其临床表现、超声、CT、MRI等影像学检查结果、术前血AFP测定及病理组织学分类情况。结果29例患儿均行完整肿瘤切除术,均治愈出院。术中出现血管、脏器损伤5例,行血管及脏器修补术;术后发生并发症4例,经再次手术探查或保守治疗后治愈。29例中,成熟畸胎瘤21例,未成熟畸胎瘤I级2例,Ⅱ级2例,Ⅲ级4例。结论小儿腹膜后畸胎瘤肿块相对较大,位置深,术前应充分了解与周围器官、组织的关系,以减少术中损伤及术后并发症;利用术前AFP测定判断肿瘤性质时要考虑年龄因素。     

脊髓圆锥马尾区畸胎瘤合并终丝牵张型脊髓拴系综合征的手术治疗

目的 探讨脊髓圆锥马尾区畸胎瘤合并终丝牵张型脊髓拴系综合征（TCS）的临床特点、手术方法及其疗效。方法 回顾性分析2007年2月～2022年3月手术治疗的50例脊髓圆锥马尾区畸胎瘤合并终丝牵张型TCS的临床资料。结果 畸胎瘤内容物及囊性部分内壁剥离切除45例,囊壁次全切除加电灼5例;50例终丝均分离、切断。术后病理均为成熟囊性畸胎瘤及内终丝结构。术后随访6个月～14.5年,中位数75个月,按Hoffman脊髓功能评分,脊髓功能状态好转27例,不变22例,恶化1例;1例畸胎瘤内膜次全切除术后复发再次手术,其余49例未见肿瘤复发,无再拴系。结论 椎管内畸胎瘤多分布于脊髓圆锥马尾区,以慢性神经压迫为表现;对合并终丝牵张型TCS,一期行畸胎瘤切除术及终丝切断脊髓栓系松解术,疗效满意。     

骶尾部畸胎瘤经肛脱出伴直肠脱垂治疗体会

探讨骶尾部畸胎瘤经肛脱出伴直肠脱垂治疗效果,术后给予广谱抗生素及抗厌氧菌药物联合治疗。术后两周逐渐拆线,伤口一期愈合,随访半年,患儿无不适。