intrapericardial malignant teratoma
Introduction
Introduction to malignant teratoma in the pericardium According to domestic and foreign literatures: malignant teratoma in the pericardium is a special pathological form of teratoma in the pericardium. It has a high degree of malignancy. It is easy to invade the ventricle, atrium and ascending aorta in the early stage, causing a series of physiological and pathological conditions. change. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: arrhythmia
Cause
Causes of malignant teratoma in the pericardium
(1) Causes of the disease
The disease is a congenital embryonic developmental malformation. A group of distorted pluripotent stem cells originating from the three germ layers often occur near the ascending aorta of the heart. They can exist alone or coexist with the teratoma of the anterior mediastinum and other parts. .
(two) pathogenesis
The pathological features of the disease mainly depend on the size and growth rate of the tumor at the beginning of the tumor. If it grows faster during the fetal period, it can cause pericardial effusion or hemorrhage, tamponade or non-immune fetal edema and cardiogenic breathing. Embarrassing, which is often one of the main causes of intrauterine death, if the tumor grows slowly or relatively static, a few cases can continue to be discovered in adolescence or even adulthood, because the tumor invades the pericardium and pleura, and continues to oppress the heart, Can cause chest or precordial tingling and abnormal sinus rhythm.
Prevention
Prevention of malignant teratoma within the pericardium
1. Prevention of tumors is different from the prevention of common infectious diseases. Because its etiology and pathogenesis are complex, its meaning is far from being able to include only the elimination of pathogenic factors. Therefore, the concept of cancer prevention highlights the elimination of the cause, that is, the prevalence of cancer. On the basis of etiology, reduce or eliminate pathogenic factors, treat precancerous conditions, and fully use comprehensive treatment to improve the treatment level of tumors, reduce the mortality rate, and maximize the effective control of tumors.
2. Early detection, comprehensive diagnosis and early treatment of the comprehensive measures, the disease is the first choice for surgical resection, but can be completely removed, although partial resection can alleviate clinical symptoms, but the prognosis is poor.
Complication
Complications of malignant teratoma in the pericardium Complications arrhythmia
There may be complications such as arrhythmia and pericardial tamponade.
Symptom
Symptoms of malignant teratoma in the pericardium Common symptoms Electrocardiogram abnormal pre-cardiac occult pain pericardial effusion Pericardial tachycardia Cardiac respiratory distress contraction
Both men and women can develop the disease, but the number of women is significantly higher than that of men. It is more common in infants and young children. Due to the limited volume of pericardium under normal circumstances, the initial manifestation of this disease is the pericardial space-occupying effect, which can cause chest discomfort or precordial anterior Pain, tumor stimulation and compression of the heart itself, can induce abnormal sinus rhythm, chest auscultation or electrocardiogram can occur sinus tachycardia, ventricular tachycardia and extra-systolic contraction, tumor invasion of the pericardium, Cause pericardial oozing to cause pericardial effusion, if the exudation is more, the amount of pericardial effusion is too large, acute pericardial tamponade or cardiogenic respiratory distress may occur, resulting in death of the child, rapid tumor growth, self-destruction or necrosis Bloody pericardial effusion may appear, and the chest shadow may be widened, showing a typical "flask-like" appearance, and the apex beat is weakened, and the diagnosis can be confirmed by pericardial puncture.
Examine
Examination of malignant teratomas in the pericardium
1. Echocardiography: The dense images or echoes of the pericardial masses are seen on the ultrasound, showing their respective echo focal lengths. These tumors are attached to the aorta and pulmonary artery roots of the heart, surrounding the aorta and superior vena cava, and compressing the heart. A large amount of pericardial effusion can be seen on the ultrasound.
2. Chest X-ray: full heart and waist, increased heart shadow, etc., teratoma can be seen on the chest radiograph calcified area, pericardial cavity inflation (CO2) contrast angiography, may show the outline of the pericardial mass.
Diagnosis
Diagnosis and diagnosis of malignant teratoma in pericardium
diagnosis
Early patients have no obvious clinical symptoms and are often difficult to diagnose. If chest discomfort or tingling in the precordial area occurs, the electrocardiogram only indicates abnormal heart rate and no specificity. Common chest X-ray examination often overlaps with the heart image, which may cause missed diagnosis or misdiagnosis. In recent years, imaging has developed rapidly. Modern high-tech imaging equipment and technology have become the main examination methods for the diagnosis of teratoma in the pericardium. Comprehensive examinations such as echocardiography or photocardiographic fluorescence photoimaging and radionuclide scanning can be performed. A dense image or echo of the mass in the pericardium and a large number of pericardial effusions were found. Computerized tomography (CT) for high-density tissues such as fat, water, soft tissue, bones, high resolution, and pericardial teratoma Preoperative diagnosis is possible, magnetic resonance imaging (MRI), using the blood flow effects of cardiovascular blood, is also very meaningful for the diagnosis of this disease.
Differential diagnosis
1. Anterior mediastinal teratoma: The onset of disease is mild, the course of disease is generally longer, often the tumor grows more and causes the symptoms of adjacent organs to come to the doctor. The teenagers are more common, with little or no pericardial effusion and heart compression symptoms. The diagnosis of chest radiograph can be clarified. When there are difficulties in distinguishing individual cases, a chest CT scan is feasible, which is generally not difficult to identify.
2. Malignant thymoma: Generally, the onset is more urgent, there are chest tingling and discomfort in the precordial area. Chest radiograph and CT show that the mass is located in the anterior superior mediastinum. Before the heart shadow, it is easy to establish in combination with clinical diagnosis.
