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Mediastinal masses
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Brent R. Weil, Robert C. Shamberger
Cystic lesions may be differentiated by their structure and location. A teratoma generally has both cystic and solid components with areas of varying density that are well demonstrated on the CT scan. Most lymphatic malformations have multiple cysts with very thin walls which often extend up into the neck. Only a small proportion is limited entirely to the anterior mediastinum. Thymic cysts are often single, thin-walled, and contiguous with the thymus. Pericardial cysts arise in the inferior portion of the chest adjacent to the pericardium.
Germ Cell Tumors of the Central Nervous System
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Matthew J. Murray, Ute Bartels, James C. Nicholson
CNS teratoma may occur in isolation or as part of a mixed tumor, either combined with germinoma or non-germinomatous malignant components, or rarely with non-GCT malignant components. The main challenge in the management of teratoma is to achieve a complete surgical resection, as there is very little evidence to support the use of adjuvant chemotherapy or radiotherapy in their management. When they are combined with germinoma, there will inevitably be a residual tumor on imaging following chemotherapy and/or radiotherapy for the malignant component. Similarly, in a mixed malignant tumor treated on an NGGCT strategy with a substantial teratoma component, there will also inevitably be a residual tumor following chemotherapy, which is likely to warrant surgical removal. In some cases, “growing teratoma syndrome”99 follows chemotherapy for NGGCT (Figure 16.7), where the tumor enlarges on chemotherapy, but in the face of normalization of tumor markers, which were initially raised at diagnosis. Such cases warrant surgery prior to continuation of treatment (Figure 16.7). Where resection is not deemed feasible and the tumor continues to grow, in the absence of treatable malignant components as indicated by markers, the use of cell cycle inhibitors shows early promise; teratomas expressing the retinoblastoma protein may respond to inhibition of cyclin-dependent kinases (CDK) 4 and 6.100–102
DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Be aware that oestrogen-secreting ovarian tumours may give rise to endometrial hyperplasia and endometrial carcinoma. These tumours may also present with sexual pseudoprecocity in children. Arrhenoblastomas (Sertoli-Leydig cell tumours) are associated with masculinization and rarely with malignancy. Teratomas are the second most common malignant ovarian germ-cell tumour and contain neural elements, cartilage and epithelial tissue.
Differential Activation of Immune Effector Processes in Mature Compared to Immature Sacrococcygeal Teratomas
Published in Fetal and Pediatric Pathology, 2022
Mette Hambraeus, Jenny Karlsson, Ioanna Kasselaki, Catharina Hagerling, Lars Hagander, David Gisselsson
In conclusion, we found SCTs to be genetically stable tumors with a differential molecular profile compared to other pediatric solid tumors. We found expression in SCTs of genes involved in transcriptional regulation, coding for DNA binding proteins as well as proteins regulating miRNA activity of importance for early germ cell development. Comparative analysis of mature and immature teratomas showed high expression of genes involved in immune processes in mature teratomas. The study is limited by the low patient number, and further studies should include mature and immature SCTs of comparable gestational ages. Molecular profiling of SCTs has not been reported previously and the study is strengthened by the number of specimens per tumor, and the multimodal approach of analysis.
Metastatic malignant struma ovarii: a case report and review of the literature on the management of malignant struma ovarii
Published in Acta Clinica Belgica, 2022
Valerie Taelman, Mirra Boer, Paul Taelman
Mature ovarian teratomas are a type of germ cell tumors of the ovary, comprising 15–20% of all ovarian tumors. Mature teratomas are composed of epithelial tissue and can include other tissues, such as hair, skin, teeth, bone and thyroid tissue. Approximately 15% of ovarian teratomas contain thyroid tissue [1,2]. A teratoma is classified as a struma ovarii if more than 50% consists of thyroid tissue or if it contains malignant thyroid tissue [3,4]. Only 2% of mature ovarian teratomas apply to this definition of struma ovarii. Malignant transformation in struma ovarii is rare and has been reported in approximately 5% of the cases [1,2]. Distant metastasis is described in 5–16% of the cases [5,6]. In the Belgian Cancer Registry, 14 cases of malignant struma ovarii (MSO) were reported between 2004 and 2018 [7]. We present a case of an MSO with distant metastasis, followed by a literature review and discussion on the management of malignant struma ovarii.
First case report of papillary thyroid carcinoma arising within a functional teratoma in Graves’ disease patient
Published in Gynecological Endocrinology, 2021
Chih-Chien Cheng, Wen-Ping Yang
PTC may arise within mature ovarian teratomas[4], excessive production of thyroid hormones by PTC had ever been reported [9]. Our case was diagnosed GD in preoperative 4 years by presence of thyrotoxicosis and high plasma TRAb level, and was been treated with antithyroid drugs periodically. Two months after the oophorectomy of the teratoma, her anti-thyroid drug was discontinued because of euthyroid status and low TRAb. No specific sonographic finding of thyroid scan and the plasma levels of TSH, free T4, TRAb are subsequently within normal range in the 2 years follow up. We suspected her previous thyrotoxicosis depending on two possible conditions: (1) the ovarian tumor can autonomously produce hyperfunction (because of the tissue strong staining of thyroglobulin) and (2) GD. The diagnosis of functioning teratoma is challenging. The evidence for the presence of a functioning struma ovarii could be based on increase radioiodine uptake by the ovary. But radioiodine scanning was not performed preoperatively to our case. After resection of the ovarian lesion, thyroid function was closely monitored, the laboratory signs of hyperthyroidism remitted. These results demonstrate the possible contribution from the PTC in teratoma to hyperthyroidism in our patient. Recently, TSHR mutations may be associated with the malignant phenotype in hyperfunctioning [10]. But gene survey was not performed to our case.