RESUMO -Os tumores de células germinativas são derivados da célula germinativa primordial de localização gonadal ou extragonadal. O teratoma é um dos seus constituintes, cuja localização extragonadal mais comum é a região sacrococcígea, independente da sua classificação histopatológica em benignos ou malignos. Descrevemos três casos de teratomas sacrococcígeos e enfatizamos aspectos do diagnóstico, técnica cirúrgica e manejo complementar. PALAVRAS-CHAVE: teratoma, sacrococcígeo, neoplasias da medula espinhal. Sacrococcigeal teratoma: report of three casesABSTRACT -Germ cell tumors are originated from the primary stem cell located either in or outside the gonadal system. Teratomas are the major group, with the sacrococcygeal location being the most common extragonadal site, independent they are benign or malignant. We describe three cases of sacrococcygeal teratoma and emphasize aspects of diagnosis, surgical techniques and complementary approaches. . O teratoma apresenta implantação gonadal ou extragonadal. A região sacrococcígea é a localização extragonadal mais comum, podendo a lesão ser do tipo sólida, multicística ou formada por grande cisto único 3,4 . Nessa região encontram-se 39% a 60% dos teratomas, sejam eles benignos ou malignos [5][6][7][8][9][10]
PURPOSE: To reproduce the experimental model of gastroschisis in chicken embryos and to prove that the histopathological changes that occur in this model can be compared to those in human gastroschisis. METHODS: A total of 278 Leghorn hen (Gallus domesticus) eggs were used. The embryos were divided into three groups: the gastroschisis group, in which the umbilical cord was opened through an orifice made in the eggshell, and the intestinal loops were exposed to a mixture of amniotic liquid and allantoid; the mixture group, in which the amniotic fluid and allantoid were simply mixed without manipulating the umbilical stump and without exposing intestinal loops; and the control group which consisted of normal embryos in which no procedure was performed. The procedures were performed on the 13th day of embryo development and the study ended on the 19th day, when the intestinal loops of the embryos were removed and sent for conventional histological study and digital morphometric analysis. RESULTS: At the end of the experiment, 23 live embryos were obtained in the gastroschisis group (11.1% survival), and 18 of these presented exposed intestinal loops (8.7% success). The embryos of the gastroschisis group weighed less than those of the other two groups. The gastroschisis group also developed intestinal changes consisting of the thickening of the intestinal wall, inflammatory infiltration of the serosa and mucosa, ischemic changes in the intestinal wall and formation of a fibrin layer over the loops. These findings are characteristic of human gastroschisis and were not observed in the two other groups studied. CONCLUSION: The experimental model in chicken embryos proved able to reproduce the intestinal changes of human gastroschisis.
Neuroblastoma is the most frequent extracranial solid tumor in childhood, but it is seldom diagnosed prenatally. We report a case of adrenal neuroblastoma identified at 39 weeks' menstrual age and successfully treated by postnatal surgery and chemotherapy. Sonography revealed a hyperechoic mass in the right upper quadrant of the fetal abdomen associated with hydramnios and hydronephrosis. Two days after delivery, the tumor was resected. No metastasis was identified. The infant received 6 cycles of chemotherapy, and at 2 years of age she was well, with no signs of recurrence.
Introduction Germ cell tumors originate in the primary stem cell located either inside or outside the gonadal system. Teratomas are the major group, with the sacrococcygeal location being the most common extragonadal site, independent of their being benign or malignant. We describe five cases of sacrococcygeal teratoma and emphasize aspects of diagnosis, surgical techniques, and complementary approaches. Patients and Methods A total of five cases of sacrococcygeal teratoma were reported and a literature review was performed using an online database, Pubmed.gov. The authors emphasize aspects of diagnosis, classification, prognosis, and the therapeutic options. Results The five cases were females and the age range from 38 weeks intrauterine (ultrasonography diagnosis) to 1.5 years. The clinical presentation usually was a sacral mass or fecal constipation. The Altman classification was type 1 in three cases and type 4 in two cases. The serum levels of α-fetoprotein was normal in three cases. Preoperative high serum α-fetoprotein levels returned to normal levels 10 days after surgery. The radical surgical resection of the tumor and the coccyx was done in all cases through a posterior sacral approach and midline incision. The surgery did not compromise the neurological function. No tumor recurrence was seen in by radiologic and α-fetoprotein examinations after a medium follow-up of 15.3 years. Conclusion The sacrococcygeal region is the most frequent site of teratomas in children. Complete tumor resection and removal of the coccyx are the main objective in curative treatment of the teratoma. Diagnosis and treatment as early as possible is essential to prevent it from becoming malignant.
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