摘要
目的：探讨儿童腹部内胚窦瘤（Endodermal sinus tumor，EST）的影像诊断价值。方法：回顾性分析我院2008—2013年经手术、病理证实的36例腹部EST的临床资料及CT表现。结果：36例年龄5月～10岁，其中＜3岁的30例，平均年龄2.3岁；其中女27例，男9例。36例中4例发生于性腺（卵巢3例，隐睾1例），32例发生于性腺外，以骶尾部（17例）及盆腹腔（10例）最常见。转移12例，其中淋巴转移6例，周围浸润及血行转移12例。6例2年内复发。CT表现：肿瘤平均直径约为6 cm（1～10 cm），其中≥5 cm者25例。形态不规则20例，规则16例；平扫实性31例，囊实性5例。增强扫描早期见多发增粗迂曲小血管影，延迟扫描肿瘤周围见结节状及片絮状强化。结论：儿童腹部EST是一种高度恶性生殖细胞肿瘤，CT表现有一定的特征性，在诊断中具有重要价值。
Abstract
Objective: To evaluate imaging findings of abdominal endodermal sinus tumor(EST) in children. Methods: Thirty-six cases of pelvic and abdominal EST were retrospectively reviewed from 2008 to 2013. Clinical data and CT findings were analyzed. All cases were confirmed by operation and pathology. Results: Mean age of the patients was 2 years and 3 months(ranging from 5 months to 10 years old) and 30 patients were less than 3 years old. 27 females and 9 males were included. The tumors were located in gonads in 4 cases(3 cases in the ovary and 1 case in the cryptorchidism), and out of the gonads in 32 cases, especially in sacrococcygeal region(17 cases) and pelvic and abdominal cavity(10 cases). 12 cases had metastasis, including 6 cases of lymphatic metastases and 12 cases of infiltration and hematogenous metastases. 6 patients relapsed within 2 years. CT manifestations: mean size of the tumors was 6 cm(1～10 cm). 25 tumor were greater than 5 cm. 20 tumors showed morphologically irregular and 16 were regular. 31 cases revealed solid mass on plain CT scan and 5 cases revealed cyst-solidary mass. All tumors showed some tiny vessels and irregular reticular enhancement in post-contrast CT scan. Later, they showed nodular and flocculent enhancing around the tumor. Conclusion: EST in abdomen is a highly malignant germ cell tumor in children. CT findings have some features and have important value in diagnosis.
关键词
内胚层窦瘤 /
腹部肿瘤 /
体层摄影术 /
螺旋计算机
Key words
Endodermal sinus tumor /
Abdominal neoplasms /
Tomography /
spiral computed
吴慧莹;徐文彪;田金生;艾 斌;李建明.
儿童腹部内胚窦瘤的影像表现[J]. 中国临床医学影像杂志. 2015, 26(2): 99-104
WU Hui-ying;XU Wen-biao;TIAN Jin-sheng;AI Bin;LI Jian-ming.
Imaging findings of abdominal endodermal sinus tumor in children[J]. Journal of China Clinic Medical Imaging. 2015, 26(2): 99-104
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