TERATOMAS IN INFANCY AND CHILDHOOD - A 54-YEAR EXPERIENCE AT THE CHILDRENS-HOSPITAL-MEDICAL-CENTER
TERATOMAS IN INFANCY AND CHILDHOOD - A 54-YEAR EXPERIENCE AT THE CHILDRENS-HOSPITAL-MEDICAL-CENTER
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DOI：
10.1097/00000658-198309000-00016
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发表时间：
1983-01-01
影响因子：
9
通讯作者：
LACK, EE
中科院分区：
文献类型：
--
作者：
TAPPER, D;LACK, EE
本文对245例患者254例畸胎瘤的临床和病理特点进行了综述。所有患者年龄在21岁或以下，于1928年至1982年在儿童医院医疗中心接受治疗。肿瘤发生在以下解剖部位：骶尾骨（102例）、卵巢（94例）、头颈（14例）、腹膜后（12例）、纵隔（11例）、睾丸（8例）、中枢神经系统（9例）、肝脏（2例）、腹壁和背部（各1例）。新生儿期发现124例肿瘤（49%）。畸胎瘤的特点是包含来自所有三个胚胎胚层的元素。在初次手术时具有任何可识别的胚胎癌成分或其他恶性生殖细胞成分的肿瘤被排除在外。在几乎所有可能进行统计分析的部位，未成熟畸胎瘤明显大于成熟肿瘤。影响预后的唯一最重要的因素是肿瘤能否在初始手术时成功切除。不接受手术或只能部分切除的患者，无论使用其他治疗方法，都无法存活。根据本文报告的经验，作者得出结论：1)完全手术切除是所有儿童畸胎瘤的治疗选择；2)这是为数不多的儿童肿瘤之一，辅助治疗的决定必须个体化，特别是考虑到患者的起源位置和年龄。图片
The clinical and pathologic features of 254 teratomas from 245 patients are reviewed. All patients were 21 years of age or younger and were treated at the Children's Hospital Medical Center from 1928 to 1982. Tumors arose in the following anatomic sites: sacrococcygeal (102), ovary (94), head and neck (14), retroperitoneum (12), mediastinum (11), testes (eight), central nervous system (nine), liver (two), abdominal wall, and back (one each). One hundred twenty-four tumors (49%) were detected in the newborn period. Teratomas characteristically contained elements derived from all three embryonic germ layers. Tumors with any recognizable component of embryonal carcinoma or other malignant germ cell elements at the time of initial surgery were excluded. Immature teratomas were significantly larger than mature tumors in nearly all sites where statistical analysis was possible. The single most important factor affecting prognosis was whether the tumor could be resected successfully at initial surgery. No patient who did not undergo surgery, or in whom only partial resection was possible, survived the disease--regardless of other treatments used. Based upon the experience reported here the authors conclude: 1) complete surgical resection is the treatment of choice for all childhood teratomas; and 2) this is one of the few childhood tumors where decisions regarding adjuvant therapy must be individualized, particularly with regard to site of origin and age of the patient. Images