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Mediastinal teratoma with hydrops fetalis in a newborn and development of chronic respiratory insufficiency.

Simoncic M, Kopriva S, Zupancic Z, Jerse M, Babnik J, Srpcic M, Grosek S - Radiol Oncol (2014)

Bottom Line: Early surgical removal is important, but, the result of treatment depends on the stage of development of mediastinal organs and complications in the postoperative period.Histology examination revealed an encapsulated immature teratoma.Additional diagnostic search revealed abnormal course of both pulmonary arteries, which was probably one of the main causes of respiratory insufficiency.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery and Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia.

ABSTRACT

Background: Mediastinal fetal teratoma can be detected as a mass in the chest during a routine prenatal ultra-sound screening. Because of the pressure on mediastinal structures it can be the cause of non-immune hydrops fetalis and polyhydramnion. The development of hydrops fetalis leads to fetal death or premature delivery in most reported cases. Early surgical removal is important, but, the result of treatment depends on the stage of development of mediastinal organs and complications in the postoperative period.

Case report: A 31-year-old gravida carrying twins, with spontaneous membrane rupture at 32 weeks gestation underwent urgent caesarean section after antenatal ultrasound revealed severe polyhydramnion and hydrops fetalis in geminus A. The child was intubated immediately after birth due to severe respiratory distress. Ultrasound and X-ray revealed a tumour mass in the right hemithorax. Tumour resection was performed at the age of 7 days. Histology examination revealed an encapsulated immature teratoma. The postoperative course was complicated with respiratory insufficiency which turned into chronic at the age of eight months.

Conclusion: This is the fifth reported child with fetal mediastinal teratoma and severe hydrops fetalis that survived the neonatal period. Additional diagnostic search revealed abnormal course of both pulmonary arteries, which was probably one of the main causes of respiratory insufficiency.

No MeSH data available.


Related in: MedlinePlus

Cystic walls lined by columnar and cuboidal epithelium. Solid parts displaying brain tissue comprising of glia cells and primitive neuroepithelium.
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f4-rado-48-04-397: Cystic walls lined by columnar and cuboidal epithelium. Solid parts displaying brain tissue comprising of glia cells and primitive neuroepithelium.

Mentions: Microscopically the tumour was predominantly, in 70%, composed by immature tissue derived from different germinal layers. Cystic areas were alternating with solid tissue. The majority of the tumour was characterized by immature neuroectodermal tissue. The elements of mature glial tissue, ganglion cells and structures of choroid plexus were also randomly interspersed. Mesodermal tissue was represented by mature muscle, bone, adipose tissue, and mature and immature cartilage components with sparsely cellular mesenchymal tissue. The mature components of the tumour were also represented by the microfoci of hepatic differentiation, and pancreatic tissue, as well as sparse elements in the form of skin appendages (Figures 3,4,5). Serum human chorionic gonadotropin and alpha protein were within normal limits, and no further oncologic treatment was necessary.


Mediastinal teratoma with hydrops fetalis in a newborn and development of chronic respiratory insufficiency.

Simoncic M, Kopriva S, Zupancic Z, Jerse M, Babnik J, Srpcic M, Grosek S - Radiol Oncol (2014)

Cystic walls lined by columnar and cuboidal epithelium. Solid parts displaying brain tissue comprising of glia cells and primitive neuroepithelium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230561&req=5

f4-rado-48-04-397: Cystic walls lined by columnar and cuboidal epithelium. Solid parts displaying brain tissue comprising of glia cells and primitive neuroepithelium.
Mentions: Microscopically the tumour was predominantly, in 70%, composed by immature tissue derived from different germinal layers. Cystic areas were alternating with solid tissue. The majority of the tumour was characterized by immature neuroectodermal tissue. The elements of mature glial tissue, ganglion cells and structures of choroid plexus were also randomly interspersed. Mesodermal tissue was represented by mature muscle, bone, adipose tissue, and mature and immature cartilage components with sparsely cellular mesenchymal tissue. The mature components of the tumour were also represented by the microfoci of hepatic differentiation, and pancreatic tissue, as well as sparse elements in the form of skin appendages (Figures 3,4,5). Serum human chorionic gonadotropin and alpha protein were within normal limits, and no further oncologic treatment was necessary.

Bottom Line: Early surgical removal is important, but, the result of treatment depends on the stage of development of mediastinal organs and complications in the postoperative period.Histology examination revealed an encapsulated immature teratoma.Additional diagnostic search revealed abnormal course of both pulmonary arteries, which was probably one of the main causes of respiratory insufficiency.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery and Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia.

ABSTRACT

Background: Mediastinal fetal teratoma can be detected as a mass in the chest during a routine prenatal ultra-sound screening. Because of the pressure on mediastinal structures it can be the cause of non-immune hydrops fetalis and polyhydramnion. The development of hydrops fetalis leads to fetal death or premature delivery in most reported cases. Early surgical removal is important, but, the result of treatment depends on the stage of development of mediastinal organs and complications in the postoperative period.

Case report: A 31-year-old gravida carrying twins, with spontaneous membrane rupture at 32 weeks gestation underwent urgent caesarean section after antenatal ultrasound revealed severe polyhydramnion and hydrops fetalis in geminus A. The child was intubated immediately after birth due to severe respiratory distress. Ultrasound and X-ray revealed a tumour mass in the right hemithorax. Tumour resection was performed at the age of 7 days. Histology examination revealed an encapsulated immature teratoma. The postoperative course was complicated with respiratory insufficiency which turned into chronic at the age of eight months.

Conclusion: This is the fifth reported child with fetal mediastinal teratoma and severe hydrops fetalis that survived the neonatal period. Additional diagnostic search revealed abnormal course of both pulmonary arteries, which was probably one of the main causes of respiratory insufficiency.

No MeSH data available.


Related in: MedlinePlus