gastric teratoma
Introduction
Introduction to gastric teratoma Gastric teratoma is a rare disease. Since Eusterman et al first reported a male 31-year-old gastric teratoma in 1922, 54 cases were reported abroad in 1995, and more than 10 cases were reported in China due to tumor growth to the stomach. Causes gastric mucosal ulcers, hematemesis and melena can occur clinically. basic knowledge The proportion of sickness: 0.01% - 0.02% Susceptible people: infants Mode of infection: non-infectious Complications: anemia
Cause
Causes of gastric teratoma
Causes:
The etiology of gastric teratoma has not been elucidated, but it is generally considered to be different from teratomas from any part of the body, because it is not related to the back body axis, the embryo body wall and the chest and abdomen, but from the visceral wall, which may be other parts of the teratoma. Tumor malignancy accounts for about 1/4, and gastric teratoma is usually a benign cause.
Pathogenesis
Like other teratomas, gastric teratoma contains three germ layer components, most of which are mainly mature tissues, but some of the neural tissues show the original immature structure, the difference is that the disease is generally considered benign, and from the discovery Development to malignant, although immature neural tissue is usually seen, a few cases of pathological reports of immature teratoma, but clinically confirmed benign, simple tumor resection, without the use of chemotherapy, age, gender And gross morphology, obstructive symptoms, gastrointestinal bleeding and X-ray findings are not reliable signs of malignancy of the disease, Moriuchi integrated 40 cases of gastric teratoma, 70% of gastric teratoma grows outside the stomach, 16% grow inside and outside the stomach 14% of the stomach grows, and all tumors from the anterior wall grow out of the stomach, and tumors that grow into the stomach can cause hematemesis and melena symptoms due to mucosal ulcers.
Prevention
Gastric teratoma prevention
In daily life, we should pay attention to nutrition and rationality. Try to diversify foods as much as possible. Eat high-protein, multi-vitamins, low-fat animal fats, digestible foods, fresh fruits and vegetables, and do not eat old-fashioned or irritating things. Grilled, marinated, fried, salty foods, staple foods and coarse grains to ensure nutritional balance.
Complication
Gastric teratoma complications Complications anemia
Tumors that grow outside the stomach can cause changes in the stomach's compression, displacement, and deformation.
Symptom
Gastric teratoma symptoms common symptoms abdominal distension black stool abdominal mass
The main clinical manifestations were abdominal masses (75%), mostly in the left upper abdomen; bloating (56%); vomiting (18%); hematemesis and/or melena (15%); respiratory distress (15%); anemia (12 %).
Examine
Gastric teratoma examination
Hemoglobin decreased in patients with hematemesis and melena.
X-ray diagnosis
Gastric teratoma shows various changes in various X-ray examinations due to the size, shape and internal structure of the lesion:
(1) Abdominal plain film: In the middle upper abdomen or the whole abdomen, the uneven shadow with uneven density can be seen, the boundary can be unclear, and the intestine can be squeezed to the right front and the lower, and the strip-like bone or punctate sand-like calcification can be seen in the shadow of the mass. .
(2) Barium meal perspective: it shows that the stomach body is deformed under pressure, the small intestine is displaced downward; the filling defect can be seen in the stomach, and it can also be dilated, and there is a gas-liquid level and a large amount of fluid; or the contrast agent in the stomach is distributed along the mass. Gathered between the lobules of the mass.
(3) tincture enema: visible transverse colon, descending colon and sigmoid colon under pressure, the upper abdomen shows a huge shadow.
(4) renal pelvic venography: showing a downward shift of the left renal pelvis, there may be impressions on the upper edge of the bladder.
2.B-ultrasound
A variety of pangrams are presented. The tumor is located in the left upper abdomen. The tumor is located between the spleen and kidney. The boundary can be clearly displayed, or the lumps can be clear. The mass can be multi-atrial lobular, and the internal sound phase can be solid and multiple. Sexual cystic, or mixed, may also show calcification.
3.CT scan
According to the size and location of the lesion, various changes are shown. The boundary of the tumor can be clear or unclear. If the lesion is huge, even occupying 4/5 of the abdominal cavity, multiple organs are under pressure and the inside of the lesion is affected. The structure is disordered, the density is uneven, and it is a mixed dense shadow. It can also be composed of solid and cystic components.
4. Gastroscopic examination
Very few applications, only the size of the lesions in the stomach cavity and its surface conditions, such as bleeding, erosion and superficial ulcers, can be observed. Of course, biopsy under direct vision is an advantage, but the diagnosis of gastric teratoma is not helpful. Big.
Diagnosis
Diagnosis and differentiation of gastric teratoma
According to the disease mainly seen in male infants, left upper abdominal mass, especially accompanied by hematemesis, cerebral palsy symptoms strongly suggest the possibility of this disease, gastrointestinal barium meal examination for the growth of lesions into the stomach or extra-gastric can be diagnosed, growth to the stomach can be Caused by gastric compression, displacement, deformation changes also contribute to the diagnosis of this disease, stomach filling contrast CT examination, clearly shows the size of the tumor, location, calcification and the close relationship with the stomach, most cases can be clearly diagnosed.
Infant gastric teratoma should be differentiated from common retroperitoneal tumors in children, Wilms tumors and neuroblastomas.
