原文題目

(1)

口腔病理科 On-Line KMU Student Bulletin

- 1 -

原文題目(出處)： Oral teratoma (epignathus) in a newborn: A case report.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2012;24:59-62.

原文作者姓名： Mohammad Saeed Ahmadi, Mohsen Dalband, Elnaz Shariatpanahi

通訊作者學校： Hamadan Medical Science University of Iran 報告者姓名(組別)：黃冠倫 Intern A 組

報告日期： 101/9/3

內文：

1. Introduction Teratoma

A. Defined by Weaver et al.：a tumor consisting of multiple tissues that are not indigenous to their site of origin

B. True neoplasms, composed of tissues from all three germinal layers, usually benign in nature

C. Common sites ： Sacrococcyx, anterior mediastinum, testicle, ovary retroperitoneum

D. Head and neck area are rare, only about 10%；nasopharynx and cervical region are most common

E. Epignathus：teratoma in the oropharygeal region, 1/35,000~1/200,000 2. Case report

A. A 2.6 kg female neonate born at 38 weeks gestation in August 2010 by vaginal delivery to a 22-year-old mother (G2 P1) who had irregular antenatal examinations during pregnancy and obstetric history was unremarkable. Apgar score of the newborn was normal. Examination showed a large, bony, ﬂeshy, trapeziform mass 6cm ×5×3 cm in diameter with smooth surface covered on one side with numerous ﬁne and coarse hair and protruding from her oral cavity

B. Feeding was not possible, mild respiratory distress

C. At the initial examination the mass was mobile and attached to a stalk that originated from the hard palate

D. CT：complex mass protruding from the oral cavity, arise from the palate.

(2)

- 2 -

E. Consisted of cystic, fat, bony, and neural elements, with defined teeth within the bone

F. No anomaly and mass was localized, an excisional biopsy was planned G. Under general anesthesia, the mass was ligated and totally excised at 10th

day

H. Histopathological examination of the mass revealed mature teratoma with mature keratinising squamous epithelium, skin adnexa, adipose tissue, teeth, neurological tissue and bone formation.

I. Post-op, palatal wound epithelialized well, masseteric function and swallowing improved. Discharged home on day 28 of life. Symptom-free at 2 months follow-up

3. Discussion

A. Teratomas contain all three primordial germ cell layers B. Histologically may be mature, immature, malignant

C. Most common site：sacrococcygeal region (nearly 40%)；rare in head and neck region (<5%)

D. Teratoma are more common in female, and usually benign, Carney et al.

found malignant teratoma to be more common in men E. Teratoma three hypotheses：

i. Teratoma derive from totipotential cells sequestered during embryogenesis

ii. Germ cells may give rise to teratomas by parthenogenetic development iii. Derive from incomplete formation of Siamese twins

F. Resection is the treatment of choice

G. Prognosis worsens as the size of tumor increases, mortality rate of teratoma in head and neck region are generally high (airway obstructed or difficulty in intubation)

題號題目

1 Which is not the common development site of teratoma (A) Testis

(B) Ovarian (C) Liver

(D) Sacrococcyx 答案

(C )

出處：Oral and Maxillofacial Pathology (third edition), P.34

(3)

- 3 -

題號題目

2 Which one is not true ?

(A) The teratoma composed of tissue from all three germ layers

(B) Teratoma in oral cavity are common and usually acquired after birth (C) Teratoma may be mature, immature, malignant

(D) Teratoma in the oropharygeal region also called epignathus 答案

(B )

出處：Oral and Maxillofacial Pathology (third edition), P.34