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oai:soar-ir.repo.nii.ac.jp:00004369 2023-02-24T00:51:46Z 461:463:464:557

心タンポナーデを来した前縦隔原発混合型胚細胞腫瘍の１剖検例 An Autopsy Case of Acute Cardiac Tamponade Induced by Primary Anterior Mediastinal Mixed Germ-Cell Tumor 堀尾, 哲郎 加藤, 正裕 関, 千夏 伊藤, 信夫 重松, 秀一 cardiac tamponade anterior mediastinal tumor mature cystic teratoma superior vena cava syndrome (SVCS) yolk sac tumor 心タンポナーデ 前縦隔腫瘍 成熟型囊胞性奇形腫 上大静脈症候群 卵黄囊腫瘍 We report an unusual autopsy case of a 4-year-old girl with acute cardiac tamponade resulting from a primary anterior mediastinal mixed germ-cell tumor that penetrated the pericardial sac. The patient was admitted for the evaluation of symptoms of nocturnal fever, cough, facial edema, and superior vena cava syndrome.She was found to have a large anterior mediastinal mass 10 cm in diameter on chest radiographs. Serological examination showed highly elevated serum alpfa-fetoprotein with normal human chorionic gonadotropin. Immediately following admission she was treated with combination chemotherapy in addition to irradiation,but she developed sudden dyspnea and died 4 days later.At autopsy,histology of the large mass occupying the anterior mediastinum exhibited a combined germ-cell tumor of mature cystic teratoma and yolk-sac tumor with extensive hemorrhage and necrosis. Immunohistochemically,yolk-sac tumor elements were strongly positive for alpha-fetoprotein. Intrathoracic invasion and metastasis were observed in the pericardium, superior vena cava,and bilateral lungs.The sudden death was apparently due to acute cardiac tamponade following bleeding from the lesions of both pericardial invasion and heavy circulatory disturbance by yolk-sac tumor elements. 信州医学会 1999-12-10 jpn journal article VoR http://hdl.handle.net/10091/9266 https://soar-ir.repo.nii.ac.jp/records/4369 0037-3826 AN00120815 信州医学雑誌 47 6 505 511 https://soar-ir.repo.nii.ac.jp/record/4369/files/Shinshu_Med47-6-05.pdf application/pdf 514.4 kB 2015-09-24