Xu Changqi,Zeng Qi,Zhang Na,et al.Clinical manifestations and surgical treatment of pediatric mediastinal teratoma: Retrospective analysis of 156 cases[J].Journal of Clinical Pediatric Surgery,,21():225-230.[doi:10.3760/cma.j.cn101785-202201060-005]
Clinical manifestations and surgical treatment of pediatric mediastinal teratoma: Retrospective analysis of 156 cases
- Keywords:
- Diaphragm/SU; Diaphragm/PP; Teratoma/DI; Teratoma/PA; Teratoma/SU; Child
- Abstract:
- Objective To summarize the clinical manifestations and surgical strategies of pediatric mediastinal teratoma (MT).Methods 156 cases of MT diagnosed with surgery and pathological results from January, 2012 to December, 2021 were recruited.There were 74 males and 82 females with the mean age of 6.25 years old (17 days-15.75 years).The patients’ tumors located in the anterior mediastinum (n=129), posterior mediastinum (n=22, including 10 in vertebral canal), pericardium (n=2), lung (n=2), and esophagus (n=1).Results Clinical manifestations of the total 156 patients:cough (n=79), chest pain (n=45), chest tightness (n=40), no symptoms (n=10), lower limbs myasthenia (n=4), hemoptysis (n=2), chest wall deformity (n=2), coughing up foreign body (n=1), cardiac murmur (n=1), and abdominal pain (n=1).The procedures of tumor resection were performed via robotic surgery (n=3, 1.9%), thoracoscopic surgery (n=65, 41.7%), thoracoscopic surgery transfered to thoracotomy (n=16, 10.3%), and thoracotomy (n=72, 46.2%).All cases were confirmed with MT by postoperative pathological examination, of which 142 were mature teratoma, 14 were immature teratoma (including 7 cases of grade WHO Ⅰ, 2 cases of grade WHO Ⅱ, and 2 cases of grade WHO Ⅲ).The average follow-up time was 60 months (1-121 months), one patient suffered postoperative recurrence and received the second operation.There were 1 case of pericardial effusion, 2 cases of chylothorax, and 6 cases of diaphragmatic eventration after surgery.Conclusion Pediatric MT has complex clinical symptoms and imaging features, which requires to combine the clinical manifestations with imaging findings of MRI, CT, ultrasound for accurate diagnosis.Complete excision of mature teratoma has a favorable prognosis.In summary, surgical treatment is a safe and effective method for children with MT.Early diagnosis and ideal surgery timing and treatment based on the clinical feature of the teratoma are the key to obtain good prognosis.
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Memo
收稿日期:2022-01-29。
基金项目:北京市医院管理中心儿科学科协同发展中心专项经费资助（XTZD20180105）
通讯作者:曾骐,Email:zengqi-1@163.com