喘鳴, 哺乳不良を契機に発見に至った咽頭 ectomesenchymoma の新生児例 [in Japanese] Pharyngeal ectomesenchymoma in a newborn found through stridor and difficulty in sucking : A case report [in Japanese]
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当科にて吸気性喘鳴, 哺乳不良を契機に発見された生後1ヵ月男児の咽頭良性ectomesenchymomaを経験した. 喉頭ファイバーでは上～中咽頭にかけて腫瘍が認められ, CT, MRIにて咽頭奇形腫と診断された. 気管切開を行った上で児の成長を待ち, 生後3ヵ月時に経口的アプローチで腫瘍摘出術を施行した. 病理学的検査では神経膠組織中に横紋筋細胞が散在しており, 良性ectomesenchymomaと診断された. 術後経過は良好であり, 現在術後9ヵ月になるが再発は認めていない. 新生児咽頭腫瘍の多くは奇形腫であり, またectomesenchymomaの報告はほとんどが悪性症例であることと合わせると, 本例は極めて稀な症例である.
Ectomesenchymomas are rare tumors that appears in the brain or soft tissue and are defined as tumors including ectodermal components mainly represented by neurobrasts or ganglion cells, and differentiated mesenchymal structures that are most often a rhabdomyosarcoma. They predominantly affect young children. While most ectomesenchymomas are reportedly malignant, we present a neonatal case of a pharyngeal benign ectomesenchymoma.<br> A one-month-old male newborn came to our division with stridor and difficulty in sucking. An endoscopic laryngeal examination was performed, and a soft mass was found, extending from the upper to middle pharynx. Based on the CT scans and MR imaging, the mass was suspected as a teratoma. Since there was a high risk of respiratory obstruction, we performed a tracheotomy and waited for the child to grow. When he was three months old, we removed the mass via transoral surgery. On pathologic examination, neuroglial tissues including diffused striated muscle cells were seen and the tumor was diagnosed as a benign ectomesenchymoma. The patient has been well with no evidence of recurrence of the tumor for nine months after the extirpation.<br> Considering that most of the pharyngeal tumors in newborns are teratomas, this case of a benign ectomesenchymoma is rare.
Stomato-pharyngology 26(2), 197-201, 2013-06-10
Japan Society of Stomato-pharyngology