Massive intracranial immature teratoma: report of a case with polyhidramnios and intense pelvic pain

Soares, Fernando A.; Fischer, Sandra Elisabeth; Reis, Marlene Antonia Dos; Soares, Edson Garcia

doi:10.1590/S0004-282X1996000200021

Abstracts

A case of massive intracranial immature teratoma in a female stillborn is reported. She was the product of the second pregnancy of a 25-year-old healthy woman. The pregnancy was unremarkable until the 25th week of gestation when the mother noticed a rapid enlargement of her abdomen and intense pelvic pain. Because of the pain, a cesarean section was indicated, and a stillborn weighing 2750g with macrocephaly was delivered. The cranial contents weighed 1350g and showed a huge tumoral mass with only a rim of normal brain. A histologic diagnosis of immature teratoma was made. Massive intracranial teratomas are rare tumors and their occurrence in intrauterine life is even rarer. Their histogenesis is unknown, and there is no explanation for their continuous growth during embryogenesis. A prenatal diagnosis of this rare condition can be made by ultrasound, computed tomography, or magnetic resonance imaging.

immature teratoma; intracranial congenital tumor

Um caso de teratoma imaturo gigante do sistema nervoso central em um natimorto é relatado. Durante a gravidez, a mãe desenvolveu poli-hidrâmnio abrupto na 25ª semana de gestação e dor pélvica intensa, que levou a indicação de cesárea. O natimorto pesava 2750g, apresentava macrocefalia evidente e o conteúdo craniano pesou 1350g. Este era representado por tecido tumoral em sua maioria e apenas uma pequena rima de tecido encefálico normal. A histologia mostrou tratar-se de um teratoma imaturo. Teratomas intracranianos gigantes congênitos são neoplasias raras, de histogênese incerta e não há explicação para o crescimento contínuo e rápido durante a vida intra-uterína. O diagnóstico pré-natal pode ser realizado por ultra-sonografia, tomografía computadorizada ou ressonância magnética.

teratoma congênito; tumor intracraniano congênito

Massive intracranial immature teratoma: report of a case with polyhidramnios and intense pelvic pain

Teratoma imaturo gigante intracraniano: relato de caso com poli-hidrâmnio e dor pélvica intensa

Fernando A. Soares^I; Sandra Elisabeth Fischer^II; Marlene Antonia Dos Reis^III; Edson Garcia Soares^I

^IAssistant Professor

^IIPost Graduation Student

^IIIformer Resident

ABSTRACT

A case of massive intracranial immature teratoma in a female stillborn is reported. She was the product of the second pregnancy of a 25-year-old healthy woman. The pregnancy was unremarkable until the 25th week of gestation when the mother noticed a rapid enlargement of her abdomen and intense pelvic pain. Because of the pain, a cesarean section was indicated, and a stillborn weighing 2750g with macrocephaly was delivered. The cranial contents weighed 1350g and showed a huge tumoral mass with only a rim of normal brain. A histologic diagnosis of immature teratoma was made. Massive intracranial teratomas are rare tumors and their occurrence in intrauterine life is even rarer. Their histogenesis is unknown, and there is no explanation for their continuous growth during embryogenesis. A prenatal diagnosis of this rare condition can be made by ultrasound, computed tomography, or magnetic resonance imaging.

Key words: immature teratoma, intracranial congenital tumor.

RESUMO

Um caso de teratoma imaturo gigante do sistema nervoso central em um natimorto é relatado. Durante a gravidez, a mãe desenvolveu poli-hidrâmnio abrupto na 25ª semana de gestação e dor pélvica intensa, que levou a indicação de cesárea. O natimorto pesava 2750g, apresentava macrocefalia evidente e o conteúdo craniano pesou 1350g. Este era representado por tecido tumoral em sua maioria e apenas uma pequena rima de tecido encefálico normal. A histologia mostrou tratar-se de um teratoma imaturo. Teratomas intracranianos gigantes congênitos são neoplasias raras, de histogênese incerta e não há explicação para o crescimento contínuo e rápido durante a vida intra-uterína. O diagnóstico pré-natal pode ser realizado por ultra-sonografia, tomografía computadorizada ou ressonância magnética.

Palavras-chave: teratoma congênito, tumor intracraniano congênito.

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Aceite: 11-dezembro-1995.

Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo

Dr. Fernando A. Soares - Department of Pathology, Faculty of Medicine of Ribeirão Preto -14049-900 Ribeirão Preto SP - Brazil. Fax +55 (0)16. 633 1068. Internet address: fasoares@fmrp.usp.br

1. Arai H, Sato K, Kadota Y, Ito M, Ishimoto K, Yanai A. Skull base reconstruction in cases of intracranial teratoma extending in to the extracranial structures. Surg Neurol 1992;38:383-390.
2. Berry CL, Keeling J, Hilton C. Teratomata in infancy and childhood: a review of 91 cases. J Pathol 1969;98:241-252.
3. Buetow PC, Smimiotopoulos JG, Done S. Congenital brain tumors: a review of 45 cases. AJR 1990;155:587-593.
4. Carney JA, Thompson DP, Johnson CL, Lynn HB. Teratomas in children: clinical and pathologic aspects. J Pediatr Surg 1972;7:271-282.
5. Char G, Persaud V, Lyons B. Massive congenital intracranial teratoma: report of a case in a hydrocephalic foetus. W Ind Med J 1985;34:274-277.
6. Dearnaley DP, A'Hern RP, Whittaker S, Bloom HJ. Pineal and CNS germ cell tumors: Royal Marsden Hospital experience 1962-1987. Int J Radiat Oncol Biol Phys 1990;773-781.
7. Dolkart LA, Balcom RJ, Eisinger G. Intracranial teratoma: prolonged neonatal survival after prenatal diagnosis. Am J Obstet Gynecol 1990;162:768-769.
8. Ferreira J, Eviatar L, Schneider S. Grossman R. Prenatal diagnosis of intracranial teratoma: prolonged survival after resection of a malignant teratoma diagnosed prenatally by ultrasound. A case report and literature review. Pediatr Neurosurg 1993;19:84-88.
9. Garden JW, McManis J. Congenital orbital-intracranial teratoma with subsequent malignancy: case report. Br J Ophthalmol 1986;111-113.
10. Hahhad SF, Menezes AH, Bell WE, Godersky JC, Afifi AK, Bale JF. Brain tumors occurring before 1 year of age: a retrospective reviews of 22 cases in an 11 year period (1977-1987). Neurosurgery 1991 ;29:8-13.
11. Hunt SJ, Johnson PC, Coons SW, Pittman HW. Surg Neurol 1990;34:336-342.
12. Kuller JA, Laifer SA, Martin JG, MacPherson TA, Mitre B, Hill LM. Unusual presentation of fetal teratoma. J Perinatol 1991;11:294-296.
13. Nanda A, Schut L, Sutton LN. Congenital forms of intracranial teratoma. Childs Nerv Syst 1991;7:112-114.
14. Neiger R, Sacks LM. Massive orbital and intracranial teratoma in the newborn: a case report. J Med Assoc Ga 1989;78:811-813.
15. Oi S, Tamaki N, Kondo T, Nakamura H, Kudo H, Suzuki H, Sasaki M, Matsumoto S, Ueda Y, Katayama K. Massive congenital intracranial teratoma diagnosed in utero. Child Nerv Syst 1990;6:459-461.
¹⁶
Registro Nacional de Patologia Tumoral. Diagnósticos de câncer no Brasil - 1981/85. Brasília: Ministério da Saúde, 1991.
17. Richards SR. Ultrasonic diagnosis of intracranial teratoma in utero: a case report and literature review. J Reprod Med 1987;12:73-75.
18. Rostad S, DeMasters BKK, Manchester DK. Two massive congenital intracranial immature teratomas with neck extension. Teratology 1985;32:163-169.
19. Russel DS, Rubinstein LJ. Pathology of tumors of the central nervous system. Ed 5. Baltimore: Williams & Wilkins; 1989; 681.
20. Sabet LM. Congenital glioblastoma multiform associated with congestive heart failure. Arch Pathol Lab Med 1982; 106-31-33.
21. Saiga T, Osasa H, Hatayama H, Miyamoto T, Ono H, Mikami T. The origin of extragonadal teratoma: case report of an immature teratoma occurring in a prenatal brain. Pediatr Pathol 1991; 11:759-770
22. Sherer DM, Abramowicz JS, Eggers PC, Metlay LA, Sinkin RA, Woods JR Jr. Prenatal ultrasonographic diagnosis of intracranial teratoma and massive craniomegaly with associated high-output cardiac failure. Am J Obstet Gynecol 1993;168:97-99.
23. Takakura K. Intracranial germ cell tumors. Clin Neurosurg 1985;32:429-444.
24. Ulreich S, Hanieh A, Furness ME. Positive outcome of fetal intracranial teratoma. Ultrasound Med 1993;12:163-165.
25. Wakai S, Arai T, Nagai M. Congenital brain tumors. Surg Neurol 1984;21:597-609.
26. Whittle IR, Simpson DA. Surgical treatment of neonatal intracranial teratoma. Surg Neurol 1981;15:268-273.

Publication Dates

Publication in this collection
06 Dec 2010
Date of issue
June 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Arai H, Sato K, Kadota Y, Ito M, Ishimoto K, Yanai A. Skull base reconstruction in cases of intracranial teratoma extending in to the extracranial structures. Surg Neurol 1992;38:383-390.

[2] 2. Berry CL, Keeling J, Hilton C. Teratomata in infancy and childhood: a review of 91 cases. J Pathol 1969;98:241-252.

[3] 3. Buetow PC, Smimiotopoulos JG, Done S. Congenital brain tumors: a review of 45 cases. AJR 1990;155:587-593.

[4] 4. Carney JA, Thompson DP, Johnson CL, Lynn HB. Teratomas in children: clinical and pathologic aspects. J Pediatr Surg 1972;7:271-282.

[5] 5. Char G, Persaud V, Lyons B. Massive congenital intracranial teratoma: report of a case in a hydrocephalic foetus. W Ind Med J 1985;34:274-277.

[6] 6. Dearnaley DP, A'Hern RP, Whittaker S, Bloom HJ. Pineal and CNS germ cell tumors: Royal Marsden Hospital experience 1962-1987. Int J Radiat Oncol Biol Phys 1990;773-781.

[7] 7. Dolkart LA, Balcom RJ, Eisinger G. Intracranial teratoma: prolonged neonatal survival after prenatal diagnosis. Am J Obstet Gynecol 1990;162:768-769.

[8] 8. Ferreira J, Eviatar L, Schneider S. Grossman R. Prenatal diagnosis of intracranial teratoma: prolonged survival after resection of a malignant teratoma diagnosed prenatally by ultrasound. A case report and literature review. Pediatr Neurosurg 1993;19:84-88.

[9] 9. Garden JW, McManis J. Congenital orbital-intracranial teratoma with subsequent malignancy: case report. Br J Ophthalmol 1986;111-113.

[10] 10. Hahhad SF, Menezes AH, Bell WE, Godersky JC, Afifi AK, Bale JF. Brain tumors occurring before 1 year of age: a retrospective reviews of 22 cases in an 11 year period (1977-1987). Neurosurgery 1991 ;29:8-13.

[11] 11. Hunt SJ, Johnson PC, Coons SW, Pittman HW. Surg Neurol 1990;34:336-342.

[12] 12. Kuller JA, Laifer SA, Martin JG, MacPherson TA, Mitre B, Hill LM. Unusual presentation of fetal teratoma. J Perinatol 1991;11:294-296.

[13] 13. Nanda A, Schut L, Sutton LN. Congenital forms of intracranial teratoma. Childs Nerv Syst 1991;7:112-114.

[14] 14. Neiger R, Sacks LM. Massive orbital and intracranial teratoma in the newborn: a case report. J Med Assoc Ga 1989;78:811-813.

[15] 15. Oi S, Tamaki N, Kondo T, Nakamura H, Kudo H, Suzuki H, Sasaki M, Matsumoto S, Ueda Y, Katayama K. Massive congenital intracranial teratoma diagnosed in utero. Child Nerv Syst 1990;6:459-461.

[16] ¹⁶
Registro Nacional de Patologia Tumoral. Diagnósticos de câncer no Brasil - 1981/85. Brasília: Ministério da Saúde, 1991.

[17] 17. Richards SR. Ultrasonic diagnosis of intracranial teratoma in utero: a case report and literature review. J Reprod Med 1987;12:73-75.

[18] 18. Rostad S, DeMasters BKK, Manchester DK. Two massive congenital intracranial immature teratomas with neck extension. Teratology 1985;32:163-169.

[19] 19. Russel DS, Rubinstein LJ. Pathology of tumors of the central nervous system. Ed 5. Baltimore: Williams & Wilkins; 1989; 681.

[20] 20. Sabet LM. Congenital glioblastoma multiform associated with congestive heart failure. Arch Pathol Lab Med 1982; 106-31-33.

[21] 21. Saiga T, Osasa H, Hatayama H, Miyamoto T, Ono H, Mikami T. The origin of extragonadal teratoma: case report of an immature teratoma occurring in a prenatal brain. Pediatr Pathol 1991; 11:759-770

[22] 22. Sherer DM, Abramowicz JS, Eggers PC, Metlay LA, Sinkin RA, Woods JR Jr. Prenatal ultrasonographic diagnosis of intracranial teratoma and massive craniomegaly with associated high-output cardiac failure. Am J Obstet Gynecol 1993;168:97-99.

[23] 23. Takakura K. Intracranial germ cell tumors. Clin Neurosurg 1985;32:429-444.

[24] 24. Ulreich S, Hanieh A, Furness ME. Positive outcome of fetal intracranial teratoma. Ultrasound Med 1993;12:163-165.

[25] 25. Wakai S, Arai T, Nagai M. Congenital brain tumors. Surg Neurol 1984;21:597-609.

[26] 26. Whittle IR, Simpson DA. Surgical treatment of neonatal intracranial teratoma. Surg Neurol 1981;15:268-273.

Brasil

Brasil

Massive intracranial immature teratoma: report of a case with polyhidramnios and intense pelvic pain

Teratoma imaturo gigante intracraniano: relato de caso com poli-hidrâmnio e dor pélvica intensa

Abstracts

Publication Dates