胎儿颅内畸胎瘤1例报道并文献复习  

Report of fetal intracranial teratoma in 1 case and literature review

作　　者：廖雪 李福勇 任黔川 LIAO Xue;LI Fuyong;REN Qianchuan(Department of Obstetrics and Gynecology,Jiangjin District Central Hospital,Chongqing 402260;Department of Critical Care Medicine,Jiangjin District Hospital of Traditional Chinese Medicine,Chongqing 402260;Department of Obstetrics and Gynecology,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]重庆市江津区中心医院妇产科,402260 [2]重庆市江津区中医院重症医学科,402260 [3]西南医科大学附属医院妇产科,四川泸州646000

出　　处：《重庆医学》2021年第10期1712-1714,1720,共4页Chongqing medicine

基　　金：重庆市区域医学重点学科妇产科学(ZDXK201803)。

摘　　要：目的探讨胎儿颅内畸胎瘤的临床表现、影像学及病理组织学特征,诊断、鉴别诊断及治疗。方法分析重庆市江津区中心医院妇产科收治的1例胎儿颅内畸胎瘤终止妊娠患者的临床资料并进行文献复习。结果患者B超检查结果提示,胎儿颅内偏左侧至颈部可见大小约4.6 cm×4.1 cm囊实性混合回声,内部回声不均匀,可见大小不等片状无回声区及较多点状强回声,彩色多普勒血流成像(CDFI)显示,实性,部分可见丰富的血流信号,并可探及搏动性血流频谱,考虑畸胎瘤恶性可能性大。行依沙吖啶100 mg羊膜腔内注射引产,经阴道娩出1男性死胎,外观见左侧头颈部一包块,向外突出。死胎巨检发现左侧头颅至颈部矢状切面一肿物(4.5 cm×4.0 cm×3.0 cm),切面实性,灰白,稚嫩。病理检查发现软骨、肌肉、上皮和原始神经管等多胚层组织,考虑未成熟畸胎瘤。结论胎儿颅内畸胎瘤罕见,病死率高,终止妊娠是主要治疗手段。Objective To investigate the clinical manifestations,imaging features,histopathological features,diagnosis,differential diagnosis and treatment of fetal intracranial teratoma.Methods The clinical data of 1 patient with terminated pregnancy due to fetal intracranial teratoma admitted to the gynecology and obstetrics department of Jiangjin District Central Hospital were analyzed and the literatures were reviewed.Results The B-ultrasound examination results showed that the cystic-solid mixed echo with a size of 4.6 cm×4.1 cm was observed from the left side of the fetal skull to the neck.The internal echo is not uniform.The unequal sizes of patchy anechoic areas were seen,moreover there were more point-like strong echos.The color Doppler flow imaging(CDFI)showed the solid property and there were abundant blood flow signals in the part,and pulsatile blood flow spectrum could be detected.The possibility of malignant teratoma was considered.The induced labor was conducted with 100 mg ethacridine by intra amniotic injection,one male stillbirth was delivered through vagina.The appearance showed a mass protruding outward in the left of the head.The stillbirth autopsy found that there was a mass(4.5 cm×4.0 cm×3.0 cm)in the sagittal section of the left side of the head to neck,its section showed solid,gray and tender.The pathological examination revealed the multiple embryotic layers tissue such as cartilage,muscle,epithelium and primitive neural tube.The immature teratoma was considered.Conclusion Fetal intracranial teratoma is rare and has a high mortality rate,and the pregnancy termination is the main treatment means.

关 键 词：畸胎瘤 颅内 胎儿 治疗 预后 

分 类 号：R714.53[医药卫生—妇产科学]