In newborns and infants with teratoma tumor diseases are found in 22-25% of cases.
Places of accommodation teratomas in children are diverse: sacrococcygeal region - 38%, the ovaries - 31%, retroperitoneal space - 12%, eggs - 6%, mediastinum - 4% Other - 9%.
The origin of teratomas today tothe end and has not been studied. Some of them are malformations of the embryo tissue, while others - the result of abnormal development of one of the twin embryos, soldered together.
Neonates teratomas are usually builtfrom immature tissues and difficult to distinguish from malignant tumors. In children aged 4 months to 5 years teratomas are malignant in 50-60% of cases.
For outdoor location in teratoma sacrococcygeal region, it is easily detected at birth, as located on the buttock or the average sacrococcygeal line.
When external-internal location teratomas, tumors other than serving, there is another part of it is located between the sacrum and the rectum.
With the growth of the interior of the teratomas arisesymptoms of disorders of the pelvic organs in the form of urination, constipation or fecal incontinence. This teratoma is often welded to the coccyx, growing outwards and may be accompanied by the collapse of the skin, the accession of infection and bleeding.
Teratoma touch can be smooth orlumpy (with malignant degeneration), the skin over it - unmodified or necrotic (dead) for large size of the tumor. The consistency of the tumor benign teratoma is usually milder than in malignant. The skin temperature of the malignant teratoma is usually increased, and vascular pattern is well marked. In contrast to the benign teratoma, malignant tumor species rarely grow large.
In benign teratomas overallthe child suffers a little, if not a tumor compresses the surrounding organs and tissues. In children with malignant tumors always expressed local symptoms. In addition, there is pallor of the skin, weight loss, retarded physical development, higher temperatures, increased ESR (erythrocyte sedimentation rate). Children often are restless because of the pain, and at that point the older ones.
Ovarian teratoma long runsmalosimptomno. The first sign of the disease increase the size of the stomach is usually the case. Sometimes children complain of abdominal pain. Torsion legs ovarian teratoma may cause, but pain, vomiting and tension anterior abdominal wall muscle (the so-called "acute abdomen" syndrome).
When retroperitoneal teratoma symptoms appear,caused by compression of the surrounding organs and tissues: recurrent pain, expansion of blood vessels on the anterior abdominal wall, the presence of tumors in the stomach feeling.
Patients with outer teratomas localization (neck, testis, etc.), There is usually only local symptoms.
When chest radiography can detect metastases of lung tissue.
spine X-ray to distinguish teratoma from malformation sacral vertebrae resulting in spinal hernia.
When X-ray study of teratoma in her various inclusions can be detected.
Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) provide an opportunity to establish contact with the surrounding tissue of the tumor.
At suspicion on involvement in the neoplastic processlarge vessels used angiography (vascular contrast study), and in cases of suspected bone lesions performed radioisotope bone scan.
If possible, make a puncture of the tumor to determine the degree of maturity (malignancy) process.
Determining the level of alpha-fetoprotein (AFP), makes it possible to clarify the nature of malignant teratoma, and monitor the effectiveness of treatment.
In children with immature (malignant) teratomasapplied combined (combined) treatment. Implementation of radical surgery with immature teratoma is difficult due to the growth of the tumor and its local and distant spread (metastasis).
Radiation treatment for immature teratoma is usually used as an adjunct to non-radical operation. It should be noted slight sensitivity of malignant teratomas to radiation.
In the case of incomplete removal of immature teratoma andthe presence of metastases can be applied chemotherapy with vincristine, dactinomycin, adriamycin, cyclophosphamide, bleomycin, Vepeside, methotrexate or platinum drugs. In some cases there is a reduction in tumor size and metastasis.
The survival rate in children with immature teratomas significantly worse compared with patients having tumors of mature and largely depends on radical surgery (removal of fullness).
After the completion of the entire program of treatment childrenshould be under the constant supervision of oncologists. This is due to the fact that during incomplete (non-radical) removal of the tumor is possible recurrence (return) of the disease. This applies especially to patients suffering from malignant teratomas when after incomplete removal or inadequate treatment can cause a recurrence of the tumor in its primary location or distant metastases.