小儿恶性骶尾部畸胎瘤的治疗及预后（附26例报告）

目的：探讨小儿恶性骶尾部畸胎瘤特点、诊治方法及预后。临床资料：２６例中，男１１例，女１５例。病理分恶性畸胎瘤９例，卵黄囊瘤１７例。结果：２６例中，２４例经手术治疗，其中１６例为晚期肿瘤，术后自动出院，短期内死亡；６例分别于半年内死亡；１例原为良性，半后复发，再术后２个月死亡；１例卵黄囊瘤，术后坚持每月化疗１月，开始好，ＡＦＰ下降，全身情况好，１年后复发，放弃治疗。结论：提出早诊断、早手术、术前明确     

18例小儿骶尾部恶性畸胎瘤的护理

回顾性分析18例小儿骶尾部恶性畸胎瘤的护理。加强术前心理、瘤体护理及肠道准备,术后密切观察伤口、并发症和化疗毒副反应,有针对性的进行护理,能有效提高恶性畸胎瘤患儿的手术成功率和生存率。     

18例小儿骶尾部恶性畸胎瘤的护理

回顾性分析18例小儿骶尾部恶性畸胎瘤的护理。加强术前心理、瘤体护理及肠道准备,术后密切观察伤口、并发症和化疗毒副反应,有针对性的进行护理,能有效提高恶性畸胎瘤患儿的手术成功率和生存率。     

成人骶尾部畸胎瘤：附五例报告

成人骶尾部畸胎瘤（附五例报告）浙江医科大学附属第一医院肛肠外科（３１０００３）孟庆勇骶尾部畸胎瘤（ｓａｃｒｏｃｏｃｃｙｇｅａｌｔｅｒａｔｏｔｎａ，以下简称ＳＣＴ）好发于婴幼儿。成人极为罕见，Ｍｉｌｅｓ总结了１９５２～１９７２年英文文献报告的２４例，国...     

小儿骶尾部畸胎瘤的手术治疗

目的：回顾性总结小儿骶尾部畸胎瘤的手术治疗经验。方法：１６例小儿骶尾部畸胎瘤患者,男性５例,女性１１例,按Ａｌｔｍａｎ分类法,Ⅰ型１０例,Ⅱ型２例,Ⅲ型１例,Ⅳ型３例。临床表现主要有骶尾部包块、排便困难、呕吐、腹胀等,直肠指诊８例可触及包块。血清甲胎蛋白检测有３例升高。所有病例行手术切除肿瘤及尾骨,１２例经骶尾部手术,４例经腹和骶尾部联合手术,恶性者术后行化疗。结果：１６例患儿均获得随访,平均５８个月（７～１２０个月）,１２例良性畸胎瘤中４例因复发再次手术治疗,其中２例恶变,死于肺转移。４例恶性患儿中１例局部复发再次手术切除,３例死于肝转移。并发症包括４例术后出现缝合伤口感染,１例皮下积液,２例出现暂时性排便困难。结论：小儿骶尾部畸胎瘤需要早期诊断,治疗手段主要是经骶尾部或经腹部和骶尾部联合手术完整切除肿瘤及尾骨,恶性者应配合放化疗。     

小儿骶尾部畸胎瘤——附47例分析

 本文报道47例小儿骶尾部畸胎瘤，对其临床、病理特点以及治疗、恶变及预后进行了分析，并对AFP值测定在小儿骶尾部畸胎瘤诊断及治疗中的作用进行了讨论．     

儿童骶尾部畸胎瘤临床分析

目的:回顾性分析儿童骶尾部畸胎瘤的诊断及治疗经验。方法:49例骶尾部畸胎瘤患儿,男性12例,女性37例。按Altman分类法,I型19(38.78%)例,Ⅱ型14(28.57%)例,III型11(22.45%)例,IV型5(10.20%)例。临床表现主要为骶尾部包块、排便困难等。所有病例均手术切除肿瘤及尾骨,48例经骶尾部手术,1例经腹和骶尾部联合手术,2例病理恶性者术后行BEP方案辅助化疗。结果:43例患儿获得随访,中位随访时间47个月(3-106个月),41例随访的良性畸胎瘤患儿均未出现复发。1例成熟畸胎瘤合并卵黄囊瘤患儿术后化疗6疗程,未复发。1例卵黄囊瘤患儿术后化疗6疗程后复发行二次手术,术后4年死于肝脏及盆腔转移。结论:儿童骶尾部畸胎瘤以良性居多。早期诊断、早期手术预后好,术中完整切除尾骨及避免肿瘤破溃是预防复发及恶变的关键,对于恶性畸胎瘤彻底手术切除辅助术后化疗也可达到较高生存率。     

胎儿骶尾部成熟性囊性畸胎瘤伴神经组织分化1例

1 病案摘要 患者27岁,孕2产1,停经36周,近10天自觉胎动减少来院门诊.B超检查:宫腔和宫颈后壁分别见一86 mm×60 mm×17 mm和47 mm×34 mm×11 mm低回声区.诊断为羊水减少、胎儿腹水而收住入院行引产术:从胎儿右锁骨下打洞,经胸腔至腹腔抽吸淡黄色液体约400 ml,胎体娩出完整,已死亡.送病理作新生儿尸检.     

卵巢畸胎瘤恶变的病理及临床分析

卵巢成熟型畸胎瘤恶变不多见，我院１９６１～１９９１年收治成熟型囊性畸胎瘤恶变２２例，占同期卵巢恶性肿瘤的５．１４％。其中鳞癌１８例，腺癌与肉瘤各２例。治疗方法以手术为主，绝大多数辅以化疗。患者的预后与肿瘤的组织类型、临床分期及治疗方法有关。鳞状上皮性恶变预后较佳；临床期别愈早疗效愈好；治疗手段以细胞减灭术并辅以化疗效果较好。     

恶性肿瘤与肾功能衰竭（附18例报告）

本文报告１８例恶性肿瘤并发肾功能衰竭。原发性肝癌１３例，恶性淋巴瘤２例，胃癌、膀胱癌、阴茎癌各１例。按肾功能衰竭发病机理分为肝肾综合征１３例、急性高尿酸血症肾病２例，急性肾中毒２例，梗阻性肾病１例。对症治疗１４例，血液透析４例。２例高尿酸血症肾病经血液透析治愈。     

Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Coexistent growing teratoma syndrome (GTS) and gliomatosis peritonei (GP) arising during chemotherapy of ovarian immature teratoma (IMT) is extremely rare and can be misdiagnosed as recurrent or progressive disease. We present a 33-year-old woman diagnosed with GTS with synchronous GP during chemotherapy of IMT. She underwent ovarian cystectomy due to ovarian immature teratoma and chemotherapy were administered. The α-fetoprotein (AFP) concentration decreased from 28.7 ng/mL to normal after the second cycle. Four days after the third cycle of chemotherapy, ultrasound and CT revealed an 8-cm mass with negative tumor markers in the pouch of Douglas. An exploratory laparotomy was conducted, and a smooth round cystic-solid 8-cm mass was noted in the pouch of Douglas. Extensive peritoneal seeding glial nodules were also observed on the surface of the uterus, peritoneum, and omentum. The patient underwent a partial omentectomy, intact resection of the tumor, and resection of most of the glial nodules. Postoperative pathology demonstrated a pure mature cystic teratoma component in the mass, as well as diffuse GP involving the uterine serosa, peritoneum, and omentum; this diagnosis of GTS with synchorous GP should be considered in IMT patients with mass newly identified during chemotherapy while tumor markers are normal after treatment.     

52例卵巢恶性肿瘤腹腔化疗近期疗效观察

我院对５２例卵巢恶性肿瘤伴腹水患者进行腹腔化疗，其中Ⅰ期３例，Ⅱ期１１例，Ⅲ期３４例，Ⅳ期４例，均经病理学证实。化疗前先行抽放腹水，之后腹腔注入ＭＭＣ６ｍｇ＋ＡＴ１２５８４０～６９ｍｇ＋５－Ｆｕ５００～７５０ｍｇ，或卡铂４００～５００ｍｇ，或ＰＤＤ９０ｍｇ／ｍ２。每周１次。５２例腹腔化疗１～１１次，平均４次。用药后５２例均有好转，其中２４例腹水基本消失，３１例血性腹水转为黄色，２７例肿物明显缩小或消失，２例病情好转后再度恶化，于３月内死亡。提示卵巢恶性肿瘤伴腹水患者行腹腔化疗，近期预后良好。     

Growing Teratoma Syndrome in the Setting of Sarcoidosis: A Case Report and Literature Review

Growing teratoma syndrome (GTS) is rare and can mimic disease recurrence in patients with a history of immature teratoma. Benign hypermetabolic lymphadenopathy found on staging and surveillance computed tomography (CT) and positron emission tomography (PET) may lead to the presumption of metastatic malignancy. We report a case of a 38 year old with mixed mature and immature teratomas who developed new peritoneal masses after adjuvant chemotherapy despite a normalization of tumor markers. In addition to low FDG uptake observed in these peritoneal masses, a PET scan showed hypermetabolic lymphadenopathy and pulmonary and spleen lesions suggesting widespread metastases. Subsequent surgical resection confirmed a mixed pathology with GTS and sarcoidosis. We reviewed the current literature evidence of GTS and sarcoidosis as a benign cause of lymphadenopathy in cancer patients. We emphasize the importance of a tissue diagnosis before instituting therapy for presumed cancer recurrence to avoid potentially fatal diagnostic traps and management errors. A multiple disciplinary team approach is imperative in managing patients with suspected recurrent immature teratomas.     

Malignant Germ Cell Sacrococcygeal Tumors in Children Improved Prognosis after Introduction of Cisplatin-Containing Multiple Drug Treatment

The survival of children with malignant germ cell sacrococcygeal tumors has improved during the last few years after introduction of a multidrug protocol including cisplatinum. Treatment for 10 patients registered in 1965-1978 was not uniform and consisted of surgical resection or biopsy and radiotherapy with or without multiple drug chemotherapy (methotrexate + actinomycin D + cyclophosphamide). Only one of these patients is alive. Fifteen patients registered between 1978 and 1986 were treated with actinomycin D + cyclophosphamide + vincristine + doxorubicin + bleomycin + cisplatinum. Four patients also received radiotherapy. Seven out of these 15 children are alive without evidence of disease.     

多发恶性肿瘤的29个家系报告

本文报告了永定县医院1995年1月至2005年12月收集经临床病理确诊随访的29个家系中共75例恶性肿瘤.病种前5名依次为肝癌23例、胃癌11例、结肠癌10例、肺癌10例、食管癌4例.遗传因素决定肿瘤的易感性即机体对致癌因子的易感性,它使有些人更容易发生某种肿瘤.环境因素和肿瘤的易感性共同造成恶性肿瘤家系发病.     

103例老年妇女妇科恶性肿瘤手术治疗分析

本文回顾了103例65岁以上老年妇女妇科恶性肿瘤的手术治疗，就术前合并症、手术范围、麻醉、手术切除率和术后并发症等问题进行了分析。结果表明，如果无重要脏器的严重合并症，老年患者仍能较好地耐受较大的手术。我们认为，只要处理恰当，老年患者的手术治疗是安全的，年龄大不应被视为手术禁忌证，对老年恶性肿瘤患者的手术治疗仍应持积极态度。     

Antenatal Sonographic Diagnosis of Fetal Sacrococcygeal Teratoma with Hydrops — (A Case Report)

A rare case of sacrococcygeal teratoma (SCT) associated with hydrops diagnosed on prenatal ultrasound and subsequently confirmed on parturition is presented.     

357例中国皮肤黑色素瘤临床特征与预后分析

目的对357例皮肤黑色素瘤患者的临床特点进行分析,以了解其流行病学特点及预后相关因素。方法对我科近3年来收治的黑色素瘤患者的临床特点与预后进行记录与随访,用SPSS11.5软件,采用寿命表法进行生存分析及Cox回归进行分析。结果Ⅰ期患者的中位生存期超过144.0月,Ⅱ、Ⅲ、Ⅳ期患者的中位生存期分别为95.7月、132.0月和26.8月;肢端黑色素瘤218例(61.1%);多因素分析发现,分期及溃疡是影响生存期的独立预后因子。结论肢端黑色素瘤发病率最高,所有患者的预后与初诊时的分期及溃疡密切相关。