成人骶尾部畸胎瘤的诊断与治疗

目的 探讨成人骶尾部畸胎瘤的诊断和治疗.方法 同顾性分析17例成人骶尾部畸胎瘤的临床资料,其中有临床症状13例,无症状查体时发现4例;全部病例经手术治疗,15例经骶尾部切除,2例经腹骶联合切除,骶尾部伤口缝合10例,其余为开放或半开放式手术.结果 全部病理经术后病理诊断为畸胎瘤,1例恶变.术前正确诊断13例,误诊平滑肌瘤2例,骶尾部囊肿2例.术后随访13例,恶变1例术后1年死亡,良性病例中2例复发,经再次手术后痊愈,其余均恢复良好无复发.结论 成人骶尾部畸胎瘤因其临床表现小典型,故常误诊.病理诊断是确诊依据.彻底切除病灶可以预防复发和可能发生的恶变,手术路径可选择经骶尾或腹骶联合切除.

Diagnosis and treatment of sacrococcygeal teratoma in adults: analysis of 17 cases

Objective To investigate the diagnosis and treatment of saerocoecygeal teratoma in adults. Methods The clinical data of 17 patients with sacrococeygeal teratoma confirmed by pathological examination, 9 males and 8 females, aged 20 -53, were analyzed retrospectively. Result Correct diagnosis was made pre-operatively in 13 of the 17 patients. Two cases were misdiagnosed as with leiomyoma, and 2 cases as with saerococcygeal cyst. Pathological examination confirmed the diagnosis of teratoma in all 17 cases. Thirteen patients were followed up for 1 -5 years post-operatively. Malignant change was seen in 1 case, and 1 patient died 1 year after operation. Two patients suffered a relapse and then fully recovered after re-operation, and the other 15 patients all recovered without relapse. Conclusion Saerocoeeygeal teratoma in adults usually has no typical clinical symptom and signs and is often misdiagnosed. The pathologic examination is the base to make a definite diagnosis. Complete excision is necessary to prevent local recurrence and potential malignant transformation. The sacroeoecygeal approach or combined abdominal- sacral approach is recommended.