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Received: 2018-12-14

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Journal of Zhejiang University SCIENCE B 2019 Vol.20 No.8 P.670-678

http://doi.org/10.1631/jzus.B1800621


Adult sacrococcygeal teratoma: a retrospective study over eight years at a single institution


Author(s):  Xiang-Ming Xu, Feng Zhao, Xiao-Fei Cheng, Wei-Xiang Zhong, Jing-Peng Liu, Wei-Qin Jiang, Xiao-Kai Yu, Jian-Jiang Lin

Affiliation(s):  Department of Colorectal Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; more

Corresponding email(s):   xuxiangming@zju.edu.cn, yuxiaokai@zju.edu.cn

Key Words:  Sacrococcygeal teratoma (SCT), Clinical features, Computed tomography (CT), Magnetic resonance imaging (MRI), Surgical resection modality


Xiang-Ming Xu, Feng Zhao, Xiao-Fei Cheng, Wei-Xiang Zhong, Jing-Peng Liu, Wei-Qin Jiang, Xiao-Kai Yu, Jian-Jiang Lin. Adult sacrococcygeal teratoma: a retrospective study over eight years at a single institution[J]. Journal of Zhejiang University Science B, 2019, 20(8): 670-678.

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author="Xiang-Ming Xu, Feng Zhao, Xiao-Fei Cheng, Wei-Xiang Zhong, Jing-Peng Liu, Wei-Qin Jiang, Xiao-Kai Yu, Jian-Jiang Lin",
journal="Journal of Zhejiang University Science B",
volume="20",
number="8",
pages="670-678",
year="2019",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1800621"
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%A Jing-Peng Liu
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A1 - Jing-Peng Liu
A1 - Wei-Qin Jiang
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DOI - 10.1631/jzus.B1800621


Abstract: 
Objective: To determine the clinical, imaging, and histological features, and surgical resection modalities and outcomes of adult sacrococcygeal teratoma (SCT). Methods: Adult patients with histopathologically diagnosed SCT were enrolled in our hospital between August 2010 and August 2018. Each patient’s characteristics and clinical information were reviewed. Results: There were 8 patients in the study (2 males, 6 females) with a median age of 34 years (range, 18–67 years). The time to clinical symptoms was 14 d to 35 years, with a median time of 4 years. Six patients presented with symptoms of sacrococcygeal pain, and four with signs of sacrococcygeal mass and ulceration in the sacrococcygeal region. Six patients were evaluated using a combination of computed tomography (CT) and magnetic resonance imaging (MRI). All patients showed a presacral tumor with heterogeneous intensity on CT images. All patients underwent surgical treatment, including 6 parasacral, 1 transabdominal, and 1 combined anterior-posterior surgery cases. Seven patients were histopathologically diagnosed with benign mature SCT, and have shown no recurrence. One patient had malignant SCT, with recurrence at 84 months after surgery. After a second surgery, the patient had no recurrence within 6 months follow-up after re-resection. Conclusions: Our retrospective study demonstrated: (1) adult SCT is difficult to diagnose because of a lack of typical clinical symptoms and signs; (2) a combination of CT and MRI examination is beneficial for preoperative diagnosis; (3) the choice of surgical approach and surgical resection modality depends on the size, location, and components of the tumor, which can be defined from preoperative CT and MRI evaluation; (4) most adult SCTs are benign; the surgical outcome for the malignant SCT patient was good after complete resection. Even for the patient with recurrent malignant SCT, the surgical outcome was good after re-resection.

成年骶尾部畸胎瘤的诊治:单中心8年经验回顾

目的:探讨成人骶尾部畸胎瘤的临床表现、影像学特点、组织学特征、手术方式及预后.
方法:回顾分析2010年8月至2018年8月在我院收治经组织病理学诊断为骶尾部畸胎瘤患者的临床资料.
结果:本组患者病例8例(男2例,女6例),中位年龄34岁.6例患者表现为骶尾部疼痛,4例表现为骶尾部肿块和溃疡.采用计算机断层扫描(CT)和磁共振成像(MRI)相结合的方法进行评估,所有患者均进行手术治疗.7例经病理诊断为良性畸胎瘤,术后无复发.1例为恶性畸胎瘤,术后84个月复发,二次手术后随访6月无复发.
结论:(1)由于缺乏典型的临床表现,成人骶尾部畸胎瘤难以诊断;(2)CT和MRI检查相结合有利于术前诊断;(3)手术入路和手术切除方式的选择取决于肿瘤的大小、位置和组成,可以通过术前的CT和MRI来确定;(4)大多数成年骶尾部畸胎瘤是良性的,恶性畸胎瘤手术切除效果良好.即使对于复发性恶性畸胎瘤,再次手术效果良好.

关键词:骶尾部畸胎瘤;临床表现;计算机断层扫描;磁共振成像;手术切除方式

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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