Primarni maligni teratom medijastinuma sa lošim ishodom

  • Danica Sazdanić-Velikić University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Sremska Kamenica, Serbia
  • Dušan Škrbić University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pneumology, Sremska Kamenica, Serbia
  • Djordje Považan University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pneumology, Sremska Kamenica, Serbia
  • Mirna Djurić University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pneumology, Sremska Kamenica, Serbia
  • Dejan Vučković University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica, Serbia
  • Nevena Sečen University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Sremska Kamenica, Serbia
DOI: https://doi.org/10.2298/VSP160331386S
Ključne reči: teratom;, medijastinum, neoplazme;, dijagnostičke tehnike i procedure;, hirurgija, grudna;, neoplazme, metastaze;, radioterapija;, lečenje, palijativno.

Sažetak


Uvod. Oko 5% –10% medijastinalnih tumora kod odraslih su teratomi, od kojih su prosečno 85% benigni. Prikaz slučaja. Prikazujemo slučaj ekstragonadalnog malignog teratoma kod bolesnika starog 39 godina. Kompjuterizovanom tomografijom (KT) grudnog koša uočena je mekotkivna promena u srednjem režnju desnog plućnog krila. Posterolateralnom torakotomijom viđen je medijastinalni tumor veličine 25 cm koji je u potpunosti odstranjen. Patohistološki nalaz resektata potvrdio je maligni teratom. Jedan mesec nakon resekcije pluća urađena je pozitron emisiona tomografija – kompjuterizovana tomografija (PET-CT) celog tela koja je ukazala na progresiju bolesti. Kod bolesnika je došlo do razvoja znakova kompresije na gornju šuplju venu, zbog čega je sprovedena radioterapija medijastinuma i palijativna radioterapija metastatske promene na lumbalnom pršljenu. Nakon radioterapije bolesnik postaje inkontinentan i paraplegičan, te je nadalje sprovedena najbolja potporna terapija. Zaključak. Primarni ekstragonadalni tumori imaju lošu prognozu usled njihove relativne hemorezistencije i čestog nalaza uznapredovale bolesti u momentu postavljanja dijagnoze.

Biografije autora

Dušan Škrbić, University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pneumology, Sremska Kamenica, Serbia

Clinic for general pneumology

Djordje Považan, University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pneumology, Sremska Kamenica, Serbia

Clinic for general pneumology, Head of pulmonary policlinic

Mirna Djurić, University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pneumology, Sremska Kamenica, Serbia

Clinic for general pneumology, Head of department for acute pneumopathies

Dejan Vučković, University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica, Serbia

Center for pathology, Head of center for pathology

Nevena Sečen, University of Novi Sad, Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Sremska Kamenica, Serbia

Clinic for thoracic oncology, Head of department for chemotherapy of lung cancer, CEOs Assistant for International Cooperation

Reference

REFERENCES

Moreira AL, Chan JK, Looijenga LH, Marx A, Stroebel P, Ul-bright TM, et al. Germ cell tumours of the mediastinum. In: Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG, ed-itors. WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart. 4th ed. Geneva: World Health Organiza-tion; 2015. p. 244‒66.

Vitorović D, Rosenblum J, Thomas C, Lee J, Biller J. Primary CNS teratocarcinoma. Front Neurol 2012; 3: 14.

Giunchi F, Segura JJ. Primary malignant teratoma of lung: Re-port of a case and review of the literature. Int J Surg Pathol 2012; 20(5): 523‒7.

Mainieri-Hidalgo J, Rees-Alpizar V, Gamboa-Gonzalez I, Maniery-Breedy M. Mediastinal germ cell tumors. Surgical experience with twenty nine patients. Acta Méd Costarric 2013; 55(3):128–131. (Spanish)

Extragonadal Germ Cell Tumors Treatment. National Cancer Institute. [cited 2015 Apr 2]. Available from: http://www.cancer.gov/types/extragonadal-germ-cell/patient/extragonadal-treatment-pdq

Kantoff P. Extragonadal germ cell tumors involving the me-diastinum and retroperitoneum. [cited 2015 Sep 10]. Available from:

http://www.uptodate.com/contents/extragonadal-germ-cell-tumors-involving-the-mediastinum-and-retroperitoneum

Roy M, Bandyopadhyay R, Pandit N, Sengupta S. Superior Vena cava Syndrome: A Presenting Feature of Mediastinal Germ Cell Tumor. Oman Med J 2010; 25(2): 131‒3.

Singhal M, Jhavar D. Primary mediastinal giant teratocarcino-ma. Indian J Cancer 2008; 45(2): 73‒4.

Hainsworth J. Malignant mediastinal Germ Cell Tumors. 2011. [cited 2011 Feb 12]. Available from: http://www.health.am/cr/malignant-germ-cell-tumors

Mueller D. Teratomas and Other Germ Cell Tumors of the Mediastinum. 2015. [cited 2015 Nov 2]. Available from: http:// www.emedicine.medscape.com/article/427395

Khan N. Mediastinal Germ Cell Tumor Imaging. 2015. [cited 2015 Nov 2]. Available from: http://www.emedicine.medscape.com/article/359110

Nuti R, Bodhireddy S, Thirumala S. Mixed germ cell tumor of mediastinum/lung masquerading as hemangioma in fine needle biopsy. Indian J Pathol Microbiol 2013; 56(2): 158‒60.

Kudlinski D, Rubis P, Rudnicka-Sosin L, Leśniak-Sobelga A, Kostkiewicz M, Podolec P. Large mediastinal teratoma causing re-current pericarditis (RCD code: VI). J Rare Cardiovasc Dis 2014; 1(6): 29‒32.

Weerakkody Y, Danaher L. Mediastinal teratoma. Available from:

http://radiopaedia.org/articles/mediastinal-teratoma

Kundu S, Mandal S, Sngupta A, Dey A. A rare case of primary mediastinal non-seminomatous germ cell carcinoma in a 18 year old boy. Case Rep 2006; 23(4): 151‒3.

Dar RA, Mushtaque M, Wani SH, Malik RA. Giant intrap-ulmonary teratoma: a rare case. Case Rep Pulmonol 2011; 2011: 298653.

Buchler T, Dusek P, Brisuda A, Simonova K, Fencl P, Jarkovsky J, et al. Positron Emission Tomography and clinical predictors of survival in primary extragonadal germ cell tumors. Klin Onkol 2012; 25(3): 178‒83.

Objavljeno
2020/12/08
Broj časopisa
Vol. 75 Br. 8 (2018): August Vol. 75 (No. 8)
Rubrika
Prikaz bolesnika