Orbital teratoma
Introduction
Introduction to orbital teratoma Teratoma is a congenital cystic lesion. The teratoma is benign and malignant. It is more malignant in the testis and more benign in the eyelid. The lesion may be primary or secondary. The primary orbital teratoma is characterized by the presence of an eyeball after birth. The lesion occurs in the deep part of the ankle. The eyeball protrudes forward and can be removed from the cleft palate, exposing the cornea. Occurred on the side of the eyeball, can cause eyeball shift, and the mass of the mass and the cheeks, ankle and sinus. basic knowledge Proportion of the disease: the specific population rate is 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: eye movement disorders
Cause
Causes of orbital teratoma
Causes:
Teratoma includes tissues derived from 2 to 3 germ layers. It is believed that the occurrence of teratoma is related to embryonic tissue development and abnormal growth. The tumor tissue may be derived from a pluripotent cell in the embryonic stage, with differentiation and Form the potential of various organs and tissues.
Pathogenesis:
The pathogenesis is not fully understood. The case of teratoma in the orbit is like a complete fetus or part of the fetus. Such a peculiar medical performance is extremely rare. A typical teratoma is an irregular mass, which contains all three embryos. Derivatives of the layer, but without the characteristics of a formal fetus, although the teratoma in other parts of the body is malignant, the teratoma in the eyelid is always benign, and the cut orbital teratoma is shown as an irregular Fluctuating light-transmissive polycystic masses, teratoma transillumination is characterized by the presence of clear cysts in the lesion or by the epidermis, gastrointestinal mucosa or airway epithelial lining, isolated hyaline cartilage, cerebrospinal fluid, ependymal cyst and The choroid plexus is often present.
Prevention
Orbital teratoma prevention
1. Pay attention to the usual life and find timely treatment in time.
2. Go to bed early and get up early, exercise your body. Insufficient sleep can reduce the body's immune function, and it is also easy to stimulate the fire, causing external injuries.
3. Quit smoking, drink less and drink coffee. Smoking is the most vulnerable to damage to the respiratory surface barrier and induces disease onset. Tobacco, alcohol and coffee all stimulate nervous excitement. Some people want to "eliminate tension and fatigue", but actually weaken the body's disease resistance.
4. Keep away from allergens and stay away from crowded places.
Complication
Orbital teratoma complications Complications, eye movement disorders
Eye movement disorders and visual impairment.
Eye movement disorders: oculomotor, trochlear, and nerves have the function of controlling the movement of the extraocular muscles of the eyeball. They are often called the ocular motor nerves. When the above nerves or nerve nuclei are damaged alone or in combination, eye movements may not occur or double vision. When the lesion is completely damaged, all the extraocular muscles appear, and the eyeball is fixed. Extraocular muscle injury, infection, or extraocular muscle paralysis caused by myopathy, eye movement can also occur, clinically known as eye movement disorders.
Symptom
Symptoms of orbital teratoma Common symptoms Eyeballs protruding from the eye can not change the visual field of vision
The lesion may be primary or secondary. The primary orbital teratoma is characterized by the presence of an eyeball after birth. The lesion occurs in the deep part of the ankle. The eyeball protrudes forward and can be removed from the cleft palate, exposing the cornea. Occurred on the side of the eyeball, can cause eyeball shift, and the mass of the mass and the cheeks, the ankle and the sinus, the mass develops rapidly, the diameter can reach 10cm, it is cystic, has a sense of fluctuation, and the light is visible. Due to the enlargement of the tumor, the eye movement disorder can be made, and the eyelids become thinner; as the eyeball is aggravated, the optic nerve can be elongated, eventually leading to vision loss, and the tumor can spread to the intracranial, sinus, and teratoma. Change, secondary orbital teratoma can originate from the intracranial or sinus, early symptoms of craniocerebral and sinus, late lesions spread to the eyelids, fundus examination often difficult, sometimes can be found optic disc edema, bleeding.
Examine
Eyelid teratoma examination
Pathological examination
There is a smooth wall outside the tumor, purple gray red or grayish red, can also be gray, benign teratoma is cystic, the squamous squamous epithelium and its attachments with ectoderm differentiation, mesoderm differentiation The fat, fibrous tissue, smooth muscle, striated muscle, cartilage and bone tissue, as well as the endodermal differentiation of the respiratory tract and digestive tract mucosa and their glands, tumor cells can be changed.
Laboratory inspection
X-ray inspection
Tumor-born tumors have developed and developed. Eyeballs and cystic masses can be found after birth, showing an enlarged sacral cavity with bone loss.
2. Ultrasonic exploration
Can display a variety of acoustic characteristics: A-type ultrasound shows that there is a high peak between the eyelid and the non-echo flat, or there is a strong echo zone and no echo zone in the lesion, B-shaped ultrasound examination can be seen in the circle In the lesion, the internal echo can be expressed as strong echo, block echo or no echo according to different components in the capsule, but it is more common in echogenic cystic lesions. If there are cartilage, bones and teeth in the wall, strong echo can be seen. Spot and sound shadow, the lesion has mild compressibility, color Doppler ultrasonography showed no blood flow signal inside the tumor.
3.CT scan
It can clearly show the enlargement of the eyelid, the lesion in the sacral space and its relationship with the optic nerve and extraocular muscle. The tumor is round, the boundary is clear, the internal density is uneven or cystic, and some cases can show the bone density plaque. For teeth, bone development, tumor spread, can show the sinus, nasopharyngeal cavity, intracranial and axillary conditions, the tumor is not enhanced by contrast agents, MRI examination can be seen inside the cystic area and physical The area is mixed, and there may be calcium spots in it. Both T1WI and T2WI show a variety of signal intensity. Under the guidance of imaging, the fine needle can be sucked out to extract the slurry, mucus or fat-containing liquid.
Diagnosis
Diagnosis and diagnosis of orbital teratoma
diagnosis
On the basis of clinical features, orbital teratoma should be considered, and the systemic examination is normal, because the mass of the cyst is easy to transmit light, and the ultrasonography of the eye shows a semi-cystic mass (often in the same direction as the posterior surface of the eyeball), X Lines and CT scans showed an enlarged polycystic soft tissue mass in the enlarged eyelid, and a larger orbital teratoma could be extended into the sinus or intracranium through the tibia.
Differential diagnosis
Orbital teratoma should be differentiated from post-natal progressive ocular protrusions such as capillary hemangioma and less common rhabdomyosarcoma.
