- 期刊
Obstructive Pneumonitis as a Clinical Manifestation of an Anterior Mediastinal Mature Teratoma-A Case Report and Review of the Literature
以阻塞性肺炎做為臨床表現的前縱膈腔成熟畸胎瘤－一病例報告和文獻回顧
摘要
畸胎瘤可發生在許多的器官，包括卵巢、睪丸等生殖腺以及肺縱膈腔。畸胎瘤主要是由三個胚層中的至少兩個胚層的細胞構成。而長在前縱膈腔者，則以成熟畸胎瘤最為常見。縱膈腔的成熟畸胎瘤通常是良性的，除非腫瘤壓迫到鄰近組織或是破裂而造成反覆性的感染或是咳血，否則不會引起特定的症狀，至於引起支氣管阻塞在臨床上是較為少見。 我們報告一位女性患者以阻塞性肺炎為其臨床表現，病人雖經抗生素治療，仍無法改善其發燒之臨床症狀，住院一週後之胸部X光影像亦無改善。支氣管鏡檢查則發現右上肺支氣管開口完全為毛狀糜爛物所阻塞，電腦斷層則顯示一個密度不均的腫瘤。經手術切除腫瘤後，病人的臨床症狀發燒壑然消退。切除的腫瘤經病理檢驗證實為由毛囊、脂肪腺、以及腸腺所構成的成熟畸胎瘤。我們回顧文獻，探討縱膈腔成熟畸胎瘤的診斷，包括破裂的畸胎瘤在電腦斷層所見以及少見的症狀。
並列摘要
Teratomas have been known to occur in various organs such as the ovaries, testes, retroperitoneal sites, and the anterior mediastinum. Mature teratomas in the anterior mediastinum have been reported to comprise 60~75% of all teratomas. They are usually benign and slow-growing, with or without symptoms. Cough, dyspnea, and chest pain are the frequent symptoms. Tumor rupture may occur and cause pneumonia. We report a 58-year-old female patient presenting with an intermittent fever for 2 weeks as a result of obstructive pneumonitis. Chest computerized tomography (CT) disclosed an anterior mediastinal tumor with local invasion into the right upper lobe. Tumor excision and right upper lobe lobectomy were performed. The histopathology demonstrated the tumor to be a mature teratoma. The fever disappeared after tumor excision and the patient was discharged uneventfully. We include a discussion of relevant case reports and literature regarding the clinical symptoms, diagnosis, and management of a mature mediastinal teratoma.