BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consi...BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.CASE SUMMARY A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital.Exploratory laparotomy;total abdominal hysterectomy,right salpingooophorectomy,and lymphadenectomy were performed with optimal debulking,and surgical stage 3C was assigned to the patient.CONCLUSION In 2014,the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue.Furthermore,the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor.This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.展开更多
Extragonadal germ cell tumors are rare. The most common sites for EGGCTs are in midline locations such as the mediastinum, retroperitoneum and pineal gland. These tumors rarely present in the stomach. We describe here...Extragonadal germ cell tumors are rare. The most common sites for EGGCTs are in midline locations such as the mediastinum, retroperitoneum and pineal gland. These tumors rarely present in the stomach. We describe here a case where a middle aged man presented with typical symptoms of gastric cancer. After extensive workup, which included blood work, CT abdomen scan, upper endoscopy, and endoscopic ultrasound, the patient was diagnosed with gastric cancer. However, due to very high blood levels of alpha-fetoprotein, the specimen was sent for special histochemical staining, which demonstrated that the tumor had features of both adenocarcinoma and endodermal sinus tumor. This is a very aggressive tumor with a very poor prognosis.展开更多
Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fos...Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fossa were retrieved from PubMed and reviewed.And a 4-year-old boy diagnosed with EST in our hospital was reported.The clinical manifestations,therapy,pathologic features,and prognosis of these cases were analyzed.Results Only seven cases of the ESTs in the posterior cranial fossa were enrolled in this review,including six cases searched from the PubMed and one case from our hospital.Six patients were boy and one patient’s gender was not available from the report.Ages ranged from 1 to 5 years(mean 3.14 years).The mean tumor size in our cohort was 4.4 cm.Six cases came from East Asia.Schiller-Duval bodies were found in all seven neoplasms.All tumors were positive for alpha-fetoprotein.The alpha-fetoprotein level in serum was increased to a very high level before therapy and depressed quickly after the effective chemotherapy.The mean follow-up time was 24.4 months(range 5-52 months).Six tumors were totally removed,and four of them recurred.Three cases died including one whose tumor was partially removed.Conclusions The serum alpha-fetoprotein level is well correlated with the severity of the tumor.A combination of operation and chemotherapy might be the effective management for EST in the posterior cranial fossa.The prognosis of extragonadal intracranial EST is poor.展开更多
Case Report An female infant patient, aged 8 months old, suffered from irregular colporrhagia for a period of 1 month after which she was taken to our hospital on 30th April, 2003. A pelvic CT examination displayed a ...Case Report An female infant patient, aged 8 months old, suffered from irregular colporrhagia for a period of 1 month after which she was taken to our hospital on 30th April, 2003. A pelvic CT examination displayed a 6.5 cm×3.0 cm shadow of a soft-tissue tumor growing longitudinally in her supravaginal uterine area （Fig. 1）. The density of the shadow was uneven, in which there were irregular low-density loci, an indication of a compression of the colon and bladder and a diffuse boundary between the posterior wall of the urinary bladder and tumor. No abnormalities were found in either kidney or ovary, the liver or gall bladder. Also no obvious lesions were seen on the chest X-ray film, and routine blood and urine laboratory examinations were normal.展开更多
A 10-year-old boy appeared with a headache, mainly in the forehead, and with lethargy at noon on November 10, 2004. He reported discontinuous gas pains, no nausea, no vomiting and no blurred vision. He thought that he...A 10-year-old boy appeared with a headache, mainly in the forehead, and with lethargy at noon on November 10, 2004. He reported discontinuous gas pains, no nausea, no vomiting and no blurred vision. He thought that he had a ＂common cold＂, but treatment for 3 days produced no result. He was diagnosed as having viral encephalitis after an examination including an electroencephalogram （EEG）, blood biochemistry and lumbar puncture, etc. in a local hospital on November 15. After further treatment for 3 days his symptoms became aggravated showing instability of gait and involuntary movement of his head and extremities. Cranial CT showed： a 4.0 cm×4.0 cm×5.0 cm lump in the cerebellar vermis which intruded into the fourth ventricle inducing evident distention of the third and lateral ventricle. He was diagnosed with blastoma of the cerebellum.展开更多
目的:分析卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)患者肿瘤特异性生存期的相关影响因素,构建OYST患者肿瘤特异性生存率的列线图预测模型。方法:从监测、流行病学和结局(The Surveillance,Epidemiology,and End Results,SEER)数据库...目的:分析卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)患者肿瘤特异性生存期的相关影响因素,构建OYST患者肿瘤特异性生存率的列线图预测模型。方法:从监测、流行病学和结局(The Surveillance,Epidemiology,and End Results,SEER)数据库中筛选2000年1月—2020年12月诊断为OYST的患者共358例,将其按3:1的比例随机分为训练集(266例)和验证集(92例)。采用单因素和多因素竞争风险分析肿瘤特异性生存期的独立影响因素,构建1年、3年、5年肿瘤特异性生存率的列线图预测模型,并通过一致性指数(C指数)、受试者工作特征曲线下面积(area under the curve,AUC)、校准曲线、Hosmer-Lemeshow拟合优度检验、决策曲线分析评估模型的区分度、准确性及实用性。通过建立风险分层系统,将患者分成高、低风险人群,采用Kaplan-Meier曲线分析2组人群的生存差异。结果:多因素竞争风险分析结果显示,年龄、手术和区域淋巴结清扫是OYST患者肿瘤特异性生存期的独立影响因素。据此构建列线图预测模型,训练集和验证集的C指数分别为0.829(95%CI:0.825~0.833)和0.808(95%CI:0.804~0.812),预测1年、3年、5年肿瘤特异性生存率的AUC分别为0.927、0.833、0.815和0.982、0.880、0.745。校准曲线及HosmerLemeshow拟合优度检验显示模型预测的OYST患者肿瘤特异性生存率与实际生存率具有较好的一致性。临床决策分析曲线表明该模型有一定的临床实用性。Kaplan-Meier曲线显示高风险人群的肿瘤特异性生存率显著低于低风险人群(均P<0.0001)。结论:构建的OYST患者肿瘤特异性生存率的列线图预测模型具有良好的区分度和准确度,可帮助临床医师评估患者预后,制定个体化治疗方案改善患者预后。展开更多
文摘BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.CASE SUMMARY A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital.Exploratory laparotomy;total abdominal hysterectomy,right salpingooophorectomy,and lymphadenectomy were performed with optimal debulking,and surgical stage 3C was assigned to the patient.CONCLUSION In 2014,the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue.Furthermore,the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor.This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.
文摘Extragonadal germ cell tumors are rare. The most common sites for EGGCTs are in midline locations such as the mediastinum, retroperitoneum and pineal gland. These tumors rarely present in the stomach. We describe here a case where a middle aged man presented with typical symptoms of gastric cancer. After extensive workup, which included blood work, CT abdomen scan, upper endoscopy, and endoscopic ultrasound, the patient was diagnosed with gastric cancer. However, due to very high blood levels of alpha-fetoprotein, the specimen was sent for special histochemical staining, which demonstrated that the tumor had features of both adenocarcinoma and endodermal sinus tumor. This is a very aggressive tumor with a very poor prognosis.
文摘Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fossa were retrieved from PubMed and reviewed.And a 4-year-old boy diagnosed with EST in our hospital was reported.The clinical manifestations,therapy,pathologic features,and prognosis of these cases were analyzed.Results Only seven cases of the ESTs in the posterior cranial fossa were enrolled in this review,including six cases searched from the PubMed and one case from our hospital.Six patients were boy and one patient’s gender was not available from the report.Ages ranged from 1 to 5 years(mean 3.14 years).The mean tumor size in our cohort was 4.4 cm.Six cases came from East Asia.Schiller-Duval bodies were found in all seven neoplasms.All tumors were positive for alpha-fetoprotein.The alpha-fetoprotein level in serum was increased to a very high level before therapy and depressed quickly after the effective chemotherapy.The mean follow-up time was 24.4 months(range 5-52 months).Six tumors were totally removed,and four of them recurred.Three cases died including one whose tumor was partially removed.Conclusions The serum alpha-fetoprotein level is well correlated with the severity of the tumor.A combination of operation and chemotherapy might be the effective management for EST in the posterior cranial fossa.The prognosis of extragonadal intracranial EST is poor.
文摘Case Report An female infant patient, aged 8 months old, suffered from irregular colporrhagia for a period of 1 month after which she was taken to our hospital on 30th April, 2003. A pelvic CT examination displayed a 6.5 cm×3.0 cm shadow of a soft-tissue tumor growing longitudinally in her supravaginal uterine area （Fig. 1）. The density of the shadow was uneven, in which there were irregular low-density loci, an indication of a compression of the colon and bladder and a diffuse boundary between the posterior wall of the urinary bladder and tumor. No abnormalities were found in either kidney or ovary, the liver or gall bladder. Also no obvious lesions were seen on the chest X-ray film, and routine blood and urine laboratory examinations were normal.
文摘A 10-year-old boy appeared with a headache, mainly in the forehead, and with lethargy at noon on November 10, 2004. He reported discontinuous gas pains, no nausea, no vomiting and no blurred vision. He thought that he had a ＂common cold＂, but treatment for 3 days produced no result. He was diagnosed as having viral encephalitis after an examination including an electroencephalogram （EEG）, blood biochemistry and lumbar puncture, etc. in a local hospital on November 15. After further treatment for 3 days his symptoms became aggravated showing instability of gait and involuntary movement of his head and extremities. Cranial CT showed： a 4.0 cm×4.0 cm×5.0 cm lump in the cerebellar vermis which intruded into the fourth ventricle inducing evident distention of the third and lateral ventricle. He was diagnosed with blastoma of the cerebellum.
文摘目的:分析卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)患者肿瘤特异性生存期的相关影响因素,构建OYST患者肿瘤特异性生存率的列线图预测模型。方法:从监测、流行病学和结局(The Surveillance,Epidemiology,and End Results,SEER)数据库中筛选2000年1月—2020年12月诊断为OYST的患者共358例,将其按3:1的比例随机分为训练集(266例)和验证集(92例)。采用单因素和多因素竞争风险分析肿瘤特异性生存期的独立影响因素,构建1年、3年、5年肿瘤特异性生存率的列线图预测模型,并通过一致性指数(C指数)、受试者工作特征曲线下面积(area under the curve,AUC)、校准曲线、Hosmer-Lemeshow拟合优度检验、决策曲线分析评估模型的区分度、准确性及实用性。通过建立风险分层系统,将患者分成高、低风险人群,采用Kaplan-Meier曲线分析2组人群的生存差异。结果:多因素竞争风险分析结果显示,年龄、手术和区域淋巴结清扫是OYST患者肿瘤特异性生存期的独立影响因素。据此构建列线图预测模型,训练集和验证集的C指数分别为0.829(95%CI:0.825~0.833)和0.808(95%CI:0.804~0.812),预测1年、3年、5年肿瘤特异性生存率的AUC分别为0.927、0.833、0.815和0.982、0.880、0.745。校准曲线及HosmerLemeshow拟合优度检验显示模型预测的OYST患者肿瘤特异性生存率与实际生存率具有较好的一致性。临床决策分析曲线表明该模型有一定的临床实用性。Kaplan-Meier曲线显示高风险人群的肿瘤特异性生存率显著低于低风险人群(均P<0.0001)。结论:构建的OYST患者肿瘤特异性生存率的列线图预测模型具有良好的区分度和准确度,可帮助临床医师评估患者预后,制定个体化治疗方案改善患者预后。
基金国家自然科学基金项目（No.81100414）,2013年重庆高校创新团队建设计划资助项目（Suppoaed by Program for Innovation Team Building at Institutions of Higher Education in Chongqing,2013）,国家临床重点专科建设项目（国卫办医函【2013】544号）.
