先天性小儿腰骶管内畸胎瘤一例

Congenital Pediatric Teratoma in Sacral Canal:A Case Report

畸胎瘤是儿童最常见的生殖细胞肿瘤,好发于骶尾部,具有恶性、潜能高的特点。可分为成熟型、未成熟型和恶性畸胎瘤。其中腰骶管内畸胎瘤约占椎管内肿瘤的0.15%,其发病机制尚不清楚。本病例为畸胎瘤,随着病情的发展在骶尾部和下腹部形成多处窦道,并有胶胨样分泌物流出。窦道的形成造成周围血管、神经粘连及纤维化,增加了手术难度,如有残留瘤组织易复发并有癌变的可能。为了防止窦道形成及癌变,提高患者预后,及时确诊并实施手术是治疗骶管内畸胎瘤最有效的方法。

Teratoma is the most common germ cell tumors in children. It is mostly located in saerococcygeal region and has high malignant potential. Teratoma can be divided into mature type, immature type and malignant teratoma. Teratoma in sa- cral canal accounts for 0. 15% of intraspinal tumor with unknown pathogenesis. This article reported a case of teratoma and the case has developed several fistulas with jelly - like secretions. The development of fistulas causes adhesion of surrounding blood vessels and nerves as well as fibrosis, making the operation very difficult to perform. Residual tumor will lead to relapse and pos- sible caneerization. So in order to prevent the development of fistulas and improve the patient＇s prognosis, timely diagnosis and operation are the most effective methods for teratoma in sacral canal.