成人腹膜后畸胎瘤的诊断与治疗

Diagnosis and treatment of primary retroperitoneal teratoma

目的 总结成人腹膜后原发性畸胎瘤的临床特点和诊治经验。 方法 对 36例成人腹膜后原发性畸胎瘤的临床资料进行回顾性分析。 结果 本组患者中男性 9例 ,女性 2 7例。良性病变患者 2 4例 ,占 6 6 7% ,平均年龄 (30 4± 8 0 )岁 ;恶性病变患者 12例 ,占 33 3% ,平均年龄 (39 6±10 5 )岁。肿瘤位于骶前者 19例 ,其中恶性 4例 (2 1 1% ) ;肿瘤位于中上腹部者 17例 ,恶性 8例(4 7 1% )。本组 1例患者伴肝转移未切除肿瘤 ,其它患者均作了肿瘤切除术。良性病变患者均存活 ,恶性患者 5例切除后存活 2年以上。 结论 成人腹膜后原发性畸胎瘤患者随年龄增长恶变的可能性加大 ,早期彻底手术切除是首选治疗。肿瘤恶变后积极治疗仍可取得较好疗效 ;化疗对含生殖细胞成分者有缓解作用。

Objective[WT5”BZ] To study the diagnosis and treatment of primary retroperitoneal teratoma in adults. [WT5”HZ]Methods[WT5”BZ] The clinical data of 36 adult patients with primary retroperitonal teratoma were reviewed. [WT5”HZ]Results[WT5”BZ] Nine patients were male and 27 female. Twenty four patients(66 7%) aged (30 4±8 0) years were benign, and 12 patients(36 3%) aged (39 6±10 5) years were malignant. Four (21 1%) cases of presarcal tumors and 8(47 1%) of 17 cases of epigastric tumors were malignant. Clinical features included abdominal or prescacral masses and compression symptoms with or without tumor markers. All patients, except one with liver metastasis, underwent radical resection. Patients without malignant metastasis survived,but 5 patients with malignant metastasis survived more than 2 years after operation. [WT5”HZ]Conclusions[WT5”BZ] Malignant metastasis of retroperitoneal teratoma is closely related to the age of adults. Early radical resection is the optimal treatment. Adjuvant chemotherapy can induce a short time remission in those with germ cell elements. [WT5”HZ]