Retroperitoneal mature cystic teratoma arising from intra-abdominal undescended testis in an adult

Teratomas are a type of germ-cell tumour which may contain embryological tissues from more than one germ-cell layer, usually occurring in the gonads. Primary retroperitoneal teratomas account for 1–11% of retroperitoneal neoplasms and are most commonly found in neonates and young adults. In the clinical literature, retroperitoneal mature cystic teratoma arising from an intra-abdominal undescended testis in adult males has been very rarely reported. We report a case of surgically proven retroperitoneal mature cystic teratoma arising from an intra-abdominal undescended testis in an adult male by multislice helical computed tomography and magnetic resonance imaging.     

Giant malignant sacrococcygeal germ cell tumor in a newborn: A rare case report

Malignant germ cell tumors constitute about 3%-4% of all neoplasms occurring before the age of 15. They arise in the ovaries, the testes, and in several other locations, including the lower back, the chest, the brain, and the abdomen. In infants and young children, the sacrococcygeal region is the most common site for extragonadal germ cell tumors, and teratomas account for the vast majority of sacrococcygeal germ cell tumors. Neonatal sacrococcygeal teratomas are usually benign and rarely they may contain a malignant component that is predominantly a yolk sac tumor. In this article, we describe a rare case of a male newborn with a giant sacrococcygeal mixed germ cell tumor composed of grade 3 immature teratoma and malignant yolk sac elements.     

Teratoma of the parotid region: an uncommon disease. Apropos of a case with review of the literature

Cervicofacial teratoma is an infrequently reported tumor that is usually diagnosed at birth and is very rarely seen after one year of age. In the case reported, an exceptional finding was a teratoma of the parotid region in an adolescent. A literature review underlines the rarity of the lesion, diagnosis being assisted by radiologic and CT scan imaging.     

卵巢畸胎瘤的CT表现

目的:研究卵巢畸胎瘤的CT表现,提高CT诊断的准确性。方法:搜集手术病理证实的卵巢畸胎瘤18例共计20个肿瘤,对其CT表现作回顾性分析。结果:18例卵巢畸胎瘤,平均34.2岁,其中良性囊性畸胎瘤18个,恶性未成熟畸胎瘤2个。右侧9个,左侧11个,平均最大直径87mm。17个呈圆形或椭圆形,3个为不规则形。18个见脂质成分存在。18个良性者14个显示壁结节,2个见脂-液平面;2个恶性者密度不均匀。13个见钙化或骨化。本组20个肿瘤平扫CT的敏感度100%,特异度95%,诊断符合率为95%。结论:发生于卵巢的含有脂质成分和钙化或骨化斑者应考虑本病。     

Immature Gastric Teratoma in an Infant: A Case Report

Gastric teratomas are extremely rare neoplasms and almost exclusively benign. They occur predominantly in males and generally present as a palpable abdominal mass. To our knowledge, only one adult case has been described in the Korean literature. We report a case in which an immature gastric teratoma in a 3-month-old boy was revealed by CT and US.     

消化性溃疡2981例胃镜分析

目的　了解闽南地区性溃疡发病学特点。方法　对 10年间经胃镜检查诊断为消化性溃疡的病例进行回顾分析。结果　 (1)共检出 2 981例溃疡 ,十二指肠球部溃疡 (DU) 2 198例 ,胃溃疡 (GU) 70 4例 ,复合性溃疡 (CU) 79例。 (2 )溃疡患者男女之比为 5 .5 1:1。 (3)溃疡患者平均年龄 4 1 2岁 ,球部溃疡以 30岁以下居多 ,胃溃疡以 5 0岁以上居多 ,复合性溃疡以5 0岁以上居多。结论　 (1)溃疡好发部位以球部溃疡最多见 ,胃溃疡次之 ,复合性溃疡最少。 (2 )溃疡发病男性明显高于女性。     

肿瘤内成分构成比对骶尾部畸胎瘤成熟度分型的价值

目的：探讨小儿骶尾部畸胎瘤瘤内成分构成比在骶尾部畸胎瘤成熟度分型方面的作用。方法：对28例骶尾部畸胎瘤患儿进行MRI扫描,用手动勾画体积测量法测量瘤内实性成分、脂肪和瘤内囊变体积构成比,对照术后病理,进行t检验统计学分析。结果：成熟型畸胎瘤组（A组）瘤内实性成分含量范围是（19.48±11.82）%,未成熟型及恶性畸胎瘤组（B组）瘤内实性成分构成比范围是（66.07±30.64）%,两组差异有显著性意义（P=0.000）,以41.63%作为阈值推测肿瘤成熟度,敏感度为100%,特异度为75%,准确率为89.3%,误诊率为25%,漏诊率为0%;A组瘤内脂肪含量构成比为（48.51±24.97）%,B组瘤内脂肪含量构成比为（3.97±2.45）%,两组差异有显著性意义（P=0.000）,并将10.61%作为阈值推测肿瘤的成熟度,敏感度为87.5%,特异度为100%,准确率为92.9%,误诊率为0%,漏诊率为12.5%;A组瘤内囊变成分体积构成比为（22.80±18.65）%,B组瘤内囊变体积构成比为（30.14±30.13）%,两组差异无显著性意义（P=0.434）。结论：小儿骶尾部畸胎瘤瘤内实性和脂肪成分构成比对判断肿瘤成熟度均有显著性意义,以脂肪含量灵敏度更大,特异性更高,漏诊率更小;但两者正确率相当。瘤内囊变成分构成比在小儿骶尾部畸胎瘤成熟度分型方面无显著性意义。     

Radiology-Pathology Conference: Mature teratoma arising from an intra-abdominal undescended testis in a 7-month-old infant

We report a rare case of an intra-abdominal testicular mature teratoma in a 7-month-old male infant presenting with a palpable abdominal mass and unilateral undescended testis. We describe the pathology, clinical presentation, and imaging findings of this entity. Clinical features accompanied by characteristic radiologic findings guide a provisional diagnosis that is confirmed by histologic analysis following surgical removal of the tumor. The pathogenesis and radiologic findings of testicular mature teratomas in the prepubertal population share many similarities to that of mature ovarian teratomas commonly seen in females of reproductive age. Awareness of this entity will permit the radiologist to suggest timely diagnosis and intervention when presented with a similar case.     

原发性颅内畸胎瘤的MRI诊断

目的　探讨MRI对畸胎瘤的诊断价值。方法　 9例经手术和病理证实的畸胎瘤患者 ,对其MR表现进行分析。结果　本组术前MRI诊断定位正确率为 10 0 % ,定性正确率 (8/9)为 88.8%。其MRI特征性表现为 :(1)肿瘤形态以分叶状为主 ,边界清楚。(2 )肿瘤信号多不均匀 ,表现复杂。 (3 )Gd -DTPA增强肿瘤呈不均匀强化。结论　MRI的多轴位成像及Gd -DTPA应用有助于畸胎瘤的诊断与鉴别诊断     

卵巢生殖细胞肿瘤的CT诊断

目的探讨卵巢生殖细胞肿瘤的CT表现特点.方法回顾性分析经手术病理证实的37例46个卵巢生殖细胞肿瘤的CT资料,结合病理讨论其CT表现特点.结果本组卵巢生殖细胞肿瘤中,畸胎瘤43个,内胚窦瘤2个,混合性生殖细胞瘤1个.对卵巢畸胎瘤,CT和B超的敏感性均为100%,特异性分别为93.02%和58.14%.30例38个成熟囊性畸胎瘤,CT明确诊断27例35个,均含有脂肪密度区,5个见脂液平面,11个有浮球征,16个有钙化或牙齿状影.5个未成熟畸胎瘤呈囊性或实性为主肿块,肿块内均见多发斑点状钙化和少许小片状脂肪密度影,其中1例实性成分内见盘曲的带状略低密度影.内胚窦瘤呈囊性1例,呈实性为主1例,实性肿块内见较大的不规则低密度坏死区.混合性生殖细胞瘤呈实质性,不规则形.结论卵巢畸胎瘤和内胚窦瘤的CT表现具有各自的特点,尤其是畸胎瘤,具有特征性表现,与B超相比,CT是更好的检查方法.     

青年人胃癌43例临床分析

目的探讨35岁以下青年人胃癌的临床特征，提高对本地区青年人胃癌的诊治水平。方法回顾性分析我院近10年来收治的43例青年人胃癌病例资料。结果43例青年人胃癌，占同期全部胃癌病例的7．3％，男性16例，占37．2％；女性27例，占62．8％；年龄最小18岁。病理分类以弥漫型癌多见，占32例，肠型胃癌11例。肿瘤的TNM分期中Ⅳ期病例占55．8％。结论青年人胃癌恶性程度高，较难早期诊断，确诊的主要方法为胃镜和上消化道造影检查，并经手术及病理证实，提高对青年人胃癌的诊治水平对早期诊断、提高疗效、改善预后意义重大。     

纵隔畸胎瘤的CT诊断

目的探讨纵隔畸胎瘤的CT特点,提高该病的诊断准确性。方法回顾性分析35例经临床和病理证实的纵隔畸胎瘤患者的CT资料。结果纵隔畸胎瘤绝大多数(97.1%)位于前纵隔中上部。纵隔畸胎瘤包括囊性畸胎瘤(60.0%)和实质性畸胎瘤(40.0%)2大类,其内可以观察到多种胚层的各种组织。囊性畸胎瘤(21例)CT表现为囊状水样密度块影,大多数具有“显壁囊肿”的特点。实质性畸胎瘤(14例)CT表现为混杂密度软组织块影。恶性畸胎瘤(5例)与周围组织间脂肪间隙消失,并对周围大血管呈全包绕或大半包绕状态。纵隔畸胎瘤可产生胸腔积液(6例)和心包积液(12例)。结论纵隔畸胎瘤具有明显的CT特点。CT在纵隔畸胎瘤的诊断和鉴别诊断中具有重要价值。     

T2期胃癌的临床病理特征和CT评估

目的 探讨T2期胃癌的临床病理特征及CT评估. 资料与方法 选取141例行胃切除术的T2期胃癌患者,对其临床病理特征及CT分期进行分析. 结果 在141例患者中,60例(42.6%)肿瘤浸润至浅肌层,72例(51.1%)肿瘤浸润至深肌层,9例(6.4%)肿瘤浸润至浆膜下.与浸润至深肌层患者相比,浸润至浅肌层者的肿瘤体积更小,分化程度更高.两组间在患者性别、年龄、肿瘤部位、肿瘤的大体形态、淋巴结转移及病理分期等方面差异均无统计学意义.CT对T2期胃癌患者T分期、N分期及M分期的准确率分别为92.2%、72.3%和92.3%;对于转移淋巴结判断的敏感性为77.9%,特异性为65.6%.综合判断CT对于胃癌TNM分期的准确性为68.8%. 结论 T2期胃癌患者的临床病理特征明确,浸润至浅肌层的肿瘤体积更小,分化程度更高.CT在T2期胃癌患者的TNM分期上的准确性较高.     

Gastric tumors with fatty components. CT findings and differential diagnosis

PURPOSE: To assess the role of CT in diagnosing and characterizing gastric fatty tumors. MATERIAL AND METHODS: We reviewed the CT scans of 16 patients (8 men, 8 women, mean age 52 years) with gastric fatty tumors (11 lipomas, 3 liposarcomas, 1 angiolipoma, 1 teratoma) examined from 1990 to 1999. The differential diagnosis considered primary and secondary lipomatosis, carcinoma engulfing the perivisceral fat and thus mimicking a liposarcoma, mesenchymal gastric and primary peritoneal tumors. RESULTS: Lipomas involved the fundus (7/11), the body (3/11), the antrum (1/11). Multifocality was found in one case. Lesions size ranged 25 to 65 mm (mean 35 mm). All the lipomas showed homogeneous structure with negative (-30 -100) HU values. A pseudocapsule was demonstrated in 7/11 cases. No infiltrative growth was demonstrated. The angiolipoma located in the fundus showed a vascular component with strong contrast enhancement. All the liposarcomas were bigger than 10 cm and there was a strong correlation between pathologic specimen and CT findings. The differentiated liposarcomas showed the classic heterogeneous fatty density; on the contrary the myxoid and the pleomorphic types showed an aspecific structure with necrotic/cystic changes, mostly demonstrated in the myxoid type. The teratoma was a solid mass with fatty, solid, necrotic and calcified components. CONCLUSION: CT allows the diagnosis and characterization of gastric fatty tumors. The preoperative diagnosis of lipomas plays a major clinical role because it often makes surgery unnecessary.     

Immature teratoma of the ovary: correlation of MR imaging and pathologic findings

The objectives of this study were to describe MR imaging findings of immature teratoma and to correlate imaging findings with histopathologic findings. The MR findings of ten patients (age range 12–29 years, mean age 19.0 years) with pathologically proven immature teratoma were retrospectively reviewed for tumor size, presence and characteristics of fatty content, presence and characteristics of solid components, and presence of ascites and implants. The MR findings were compared with gross (n=3) and microscopic (n=10) findings. Comparisons between relative amounts of solid components and histologic grades were evaluated by Spearman rank-order correlation. On MR images all lesions appeared to be fat-containing tumors with solid components consisting of numerous cysts of various sizes. Solid tissue exhibited a wide variety of signal intensities on T2-weighted images. Punctate foci of fat were identified in all lesions, whereas fatty fluid was observed only in two. Predominant fluid content exhibited signal intensities similar to simple fluid in nine lesions. Ascites was observed in six lesions, and peritoneal dissemination in three. Pathologic studies confirmed scattered foci of adipose tissue in the solid portions of all cases, and revealed numerous cystic structure formations in these solid components. The correlation coefficient between the amount of solid tissue and the tumor grade was not significant (r_s=0.266). The MR images of immature teratoma tended to show aqueous fluids and the solid components consisting of numerous cysts with punctate foci of adipose tissue, whereas predominant fluid is sebaceous fluid in the vast majority of mature cystic teratomas. Electronic Publication     

卵巢畸胎瘤的CT表现

目的研究卵巢畸胎瘤的CT表现.方法经病理证实卵巢畸胎瘤25例,全部女性,平均年龄32.8岁.其中良性囊性畸胎瘤21例,恶性未成熟畸胎瘤4例.全部病例作了CT扫描.结果右侧12例,左侧13例,平均最大直径81mm.20例圆或椭圆形,5例不规则形.24例见脂质成分存在.21例良性者16例显示壁结节,3例为实质性肿块,2例见脂/液平面;4例恶性者密度不均匀.20/25例见钙化或骨化.2例恶性者并有腹膜转移.结论发生于卵巢的含有脂质成分和钙化或骨化斑者应考虑本病诊断.     

Value of F-FDG PET/CT in the diagnosis of primary gastric cancer via stomach distension

Objective

To clarify the usefulness of ¹⁸F-FDG PET/CT for detecting primary gastric cancer via gastric distention using a mixture of milk and Diatrizoate Meglumine.

Materials and methods

A total of 68 patients (male: 47, female: 21; age: 41–87 years) suspected of gastric carcinoma underwent ¹⁸F-FDG PET/CT imaging. After whole-body PET/CT imaging in a fasting state, the patients drank a measured amount of milk with Diatrizoate Meglumine. Local gastric district PET/CT imaging was performed 30 min later. The imaging was analyzed by semi-quantitative analysis, standardized uptake value (SUV) of the primary tumor was measured in a region of interest. The diagnosis results were confirmed by gastroscopy, pathology, and follow-up results.

Results

Of the 68 patients, 56 malignant gastric neoplasm patients (male: 37, female: 19) were conformed. The sensitivity, specificity, positive predictive value and negative predictive value of fasting whole-body PET/CT imaging for a primary malignant tumor were 92.9%, 75.0%, 94.5%, and 69.0%, respectively. The values for distension with a mixture of milk and Diatrizoate Meglumine were 91.1%, 91.7%, 98.1%, and 68.8%, respectively. The area under the curve was 0.919 ± 0.033 and 0.883 ± 0.066 for the diagnosis of gastric cancer with SUV_max in a fasting state and after intake of mixture respectively, the differences were not statistically significant (P = 0.359). Using gastric distension with a mixture of milk and Diatrizoate Meglumine, the mean ratio of the lesion's SUV_max to the adjacent gastric wall SUV_max increased significantly from 3.30 ± 3.05 to 13.50 ± 15.05, which was statistically significant (P < 0.001).

Conclusions

¹⁸F-FDG PET/CT imaging is highly accurate for the diagnosis of primary gastric carcinoma. Gastric distention can display the lesions more clearly, however, it cannot significantly improve diagnostic accuracy.     

From the archives of the AFIP. Mediastinal germ cell tumors: radiologic and pathologic correlation.

Germ cell tumors occur most frequently in the gonad but can rarely occur in extragonadal locations, usually in or near the midline. The most common extragonadal site of primary germ cell tumors is the anterior mediastinum. The most common histologic type of mediastinal germ cell tumor is mature teratoma, which is typically asymptomatic and incidentally discovered. Radiographically, these tumors appear as rounded, often lobulated masses; calcification may be seen. Imaging studies of mature teratoma frequently demonstrate cystic components and may demonstrate fat or calcium. Malignant germ cell tumors usually occur as large masses in symptomatic young male patients. Seminomas are typically of homogeneous soft-tissue attenuation, and nonseminomatous malignant germ cell tumors are typically of heterogeneous attenuation on computed tomographic scans. Therapy varies according to cell type and may include surgery, radiation therapy, or chemotherapy. Prognosis is excellent for patients with mature teratoma, good for patients with pure seminoma, and poor for patients with nonseminomatous malignant germ cell tumors and mixed germ cell tumors.     

卵巢畸胎瘤的MRI诊断价值

目的：探讨卯巢畸胎瘤的MRI征象特点及其诊断价值。方法：搜集经手术病理证实的12例卵巢畸胎瘤的MRI资料进行回顾性分析。结果：12例卵巢畸胎瘤中,左侧9例,右侧3例,最大直径13．8cm,9例为圆形或椭圆形,3例为不规则形。10例见脂质信号,6例见明显的双低钙质信号。11个良性者5例显示壁结节,2例实性肿块,1例恶性者信号欠均匀,并有腹膜转移、腹腔积液。结论：对于发生于卵巢的肿瘤,含有脂质的双高信号或钙质的双低信号考虑为卵巢畸胎瘤。     

Computed tomography and magnetic resonance features of renal Ewing sarcoma

Ewing sarcoma (ES) is a rare malignant tumor that primarily involves long and flat bones but can develop in almost any bone or soft tissue. ES accounts for 2.3-3.5% of tumors in patients under the age of 19, and is rarely found in the adult population. Sarcomas, in general, account for less than 1% of tumors in adults. Several reports of renal ES have been described in the pediatric population, but only a few cases have been described in the adult population. To the best of our knowledge, fewer than 10 cases of renal Ewing sarcoma in adults have been described in the English literature. None of these cases described the computed tomography (CT) and magnetic resonance imaging (MRI) features. We report a case of a 46-year-old woman, including CT and MRI characteristics.