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The Korean Journal of Pathology 1978;12(4): 433-440.
갑상선 기형종 -증례보고 및 문헌고찰-
Teratoma of the Thyroid Gland -A case report and literature review-
ABSTRACT
We recently experienced a case of teratoma of the thyroid gland in a 20-day-old female infant, who admitted to HYUH on March 6, 1978, due to a hen-egg sized palpable firm mess on left side of the neck from at birth without complaint of any symptoms of respiratory or swallowing difficulties. In microscopic examination of the excised tumor from patient, we found a potion of mature thyroid follicles in subcapsular area of the tumor, which shows pressure atrophy due to underlying growing tumor, and many kinds of tissues derived from three germ layers with predominant neurogenic tissues such as neuroblasts forming rosettes, glial cells, choroid plexus, and retinal anlages. From the findings of anatomic position of the tumor, histologic relation to the thyroid gland, microscopic feature of the tumor, and postoperative thyroid scanning, we diagnosed this tumor as true teratoma of the thyroid gland originated from left lobe of the thyroid gland. This is probable the first case of teratoma of the thyroid gland reporting in Korea. Teratomas of the neck are rare, and slightly more than 100 cases are reported up to date. They occur predominantly under the age of one. Teratomas of the neck arising in infant and child are almost benign except for three cases in the literature. Five cases arising in adult are malignant except for a case of recurrent infant benign teratoma. All varieties of tissues derived from three germ layers with predominance of brain tissue are found in the tumor. There has been disagreement in the classification of cervical teratoma for long time, and it is impossible to say with certainty whether the tumor originates from the thyroid gland or from the adjacent cervical tissue. For clinical evaluation of the tumor, it can be classified as a teratoma of the thyroid gland and a teratoma in the region of the thyroid gland, based on the criteria proposed by Silterman et al. The choice of treatment of cervical teratoma is early surgical removal of the tumor. The prognosis in the immediate postoperative period is excellent, and operative mortality is very low. All cased not received surgical treatment died of respiratory distress. Prolonged follow-up study is needed to establish the long-range prognosis in these patients. We reviewed literature of the teratoma of the neck and discussed on its incidence, classification, pathologic findings, the value of surgical operation, prognosis, and the necessity of long term follow-up Study.