Teratoma with malignant transformation in the anterior mediastinum: a case report.
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Malignant transformation of teratoma in the anterior mediastinum is rare; the mass usually has a long history and is seen in older patients. We report a case of teratoma with malignant transformation in the anterior mediastinum, complicated by rupture. CT revealed a lobulated, inhomogeneous cystic mass with a fat component and wall calcifications. The lateral wall was disrupted and consolidation in the adjacent left upper lobe was noted, suggesting rupture. A heterogeneously enhanced solid portion, obliterating the fat plane between the mass and the great vessels was present in the medial aspect of the mass, and pathologic examination demonstrated the presence of adenocarcinoma. (+info)
Immature gastric teratoma in an infant: a case report.
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Gastric teratomas are extremely rare neoplasms and almost exclusively benign. They occur predominantly in males and generally present as a palpable abdominal mass. To our knowledge, only one adult case has been described in the Korean literature. We report a case in which an immature gastric teratoma in a 3-month-old boy was revealed by CT and US. (+info)
The role of fetal surgery in life threatening anomalies.
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The development and evolution of fetal surgery and the recognition of the fetus as a patient came from two sources. First, were those obstetricians and perinatologists who detected life threatening anomalies before birth, and re-described a hidden mortality arising from death in utero. Ultrasonography, color Doppler ultrasound and ultrafast fetal magnetic resonance imaging have since enhanced the accuracy of prenatal evaluation. Second, were those pediatricians responsible for treating newborn infants with extremely serious problems, and that appeared untreatable, although, it was believed that they could have been treated at an earlier stage of development. After the natural history of several correctable lesions had been determined and the selection criteria for intervention developed, fetal surgery emerged as a means of improving the overall morbidity and mortality rates. (+info)
Analysis of 20 mature ovarian cystic teratoma cases in postmenopausal women.
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OBJECTIVE: To study the incidence of malignant change, diagnosis and management of mature cystic teratomas in postmenopausal women. METHODS: Twenty cases of mature cystic teratoma in postmenopausal women admitted to our hospital between January 1977 and January 1997 was retrospectively reviewed and evaluated. RESULTS: The number of postmenopausal patients with mature cystic teratoma (20) accounted for 7.6% of the total number of patients with benign ovarian teratomas (263). There were 3 cases of malignant change, which were squamous carcinoma, carcinosarcoma, and digestive gland epithelial carcinoma. The incidence of malignant change was 15%. CONCLUSION: In postmenopausal women, mature ovarian cystic teratoma should be treated as lowly malignant and should be paid much attention. (+info)
Characteristics, diagnosis and treatment of hepatic metastasis of pure immature ovarian teratoma.
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OBJECTIVE: To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment. METHODS: Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively. RESULTS: All of the hepatic metastatic tumors were located on the surface of the liver. 61.1% (11/18) of them were clinical stage III and 44.4% (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7% (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2% (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4% (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8% (14/18), and mortality rate was 22.2%. The 5- and 10-year-survival rate was 55.6% (10/18) and 38.9% (7/18), respectively. The rate of loss in follow-up was 22.2% (4/18) and 38.9% (7/18), respectively, and one patient has survived for more than 17 years. CONCLUSIONS: The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients. (+info)
Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature.
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Treatment and prognosis have not been well characterized in germ cell tumors (GCT) with a malignant nongerm cell component. Patients with a mediastinal tumor, neural or rhabdomyosarcomatous differentiation and distant metastases have the poorest prognosis. We report a rare case of mixed GCT composed of seminoma, teratoma and rhabdomyosarcoma with the rhabdomyosarcomatous component metastasized into the liver and bone marrow (BM) causing hypercalcemia. The patient was treated with differentiation-tailored chemotherapy (CHT) including a disease-adapted high-dose (HD) CHT regimen with purified autologous PBSCT (APBSCT) and pamidronate. To date, remission has lasted for 4 years. Tumor-adapted CHT including HD-CHT with APBSCT can induce long term remissions in high-risk patients with transformed GCT. A review of the literature is given. (+info)
ERK signalling and oncogene transformation are not impaired in cells lacking A-Raf.
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Previous studies have indicated an important role for the Raf family of protein kinases in controlling cellular responses to extracellular stimuli and activated oncogenes, through their ability to activate the MEK/ERKs. To investigate the specific role of A-Raf in this process we generated A-Raf deficient mouse embryonic fibroblasts (MEFs) and embryonic stem (ES) cells by gene targeting and characterized their ability to undergo proliferation, differentiation, apoptosis, ERK activation, and transformation by oncogenic Ras and Src. The A-Raf deficient cells are not disrupted for any of these processes, despite the fact that this protein is normally expressed at high levels in both cell types. This implies either that A-Raf plays no role in MEK/ERK activation, that its function is fully compensated by other Raf proteins or MEK kinases or that its role in MEK/ERK activation is highly tissue-specific. Interestingly, B-Raf and Raf-1 activity towards MEK as measured by the immunoprecipitation kinase cascade assay are both significantly increased in the A-Raf deficient MEFs. (+info)
Course and outcome of a pregnancy with a giant fetal cervical teratoma diagnosed prenatally.
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We report the course and outcome of a pregnancy involving a giant fetal neck teratoma which was diagnosed at 23 weeks of gestation. Sonographic surveillance of the fetal neck revealed continuing growth of the tumor with development of polyhydramnios. Three-dimensional ultrasound provided additional detailed information on the external extent of the lesion. Color Doppler ultrasound showed intense arterial and venous flow with low resistance indices. Cesarean section under general anesthesia was planned in close cooperation with the neonatologist, pediatric surgeon and anesthesiologist because the size of the neck mass precluded vaginal delivery. Cesarean section was performed at 34 weeks of gestation following preterm rupture of the membranes. Orotracheal intubation was not successful because of compression of the airway and a tracheostomy could not be performed because of the risk of severe fetal hemorrhage from the tumor. The neonate died from respiratory insufficiency 66 min after birth. (+info)