Teratoma mesentérico maduro en una mujer adulta: reporte de caso y revisión de la literatura / Mature mesenteric teratoma in an adult women: Case report and literature

Introducción. Los teratomas son neoplasias que surgen a partir de células germinales pluripotenciales y derivan de dos o más capas de células. Se clasifican en tumores maduros, que contienen tejidos bien diferenciados, o inmaduros, que contienen estructuras inmaduras y embrionarias. Su localización más frecuente son las gónadas; la ubicación mesentérica es infrecuente y se han descrito aproximadamente 40 casos en la literatura mundial. Dentro del abordaje diagnóstico y terapéutico, se emplea la tomografía computarizada y la resonancia magnética nuclear para caracterizar la lesión, evaluar la extensión intraabdominal y la relación con otras estructuras. El diagnóstico debe confirmarse mediante el examen histopatológico. Caso clínico. Paciente femenina de 56 años, con antecedente de carcinoma ductal infiltrante de mama izquierda en remisión, en estudios de seguimiento con hallazgo incidental en tomografía de abdomen de lesión abdominopélvica dependiente del mesenterio, contornos lisos y nivel grasa-líquido. Estudios de extensión con marcadores tumorales negativos. Resultados. Por la alta sospecha clínica e imagenológica de teratoma, fue llevada a resección quirúrgica de la lesión. El examen histopatológico confirmó el diagnóstico de teratoma quístico maduro del mesenterio. Conclusión. El teratoma mesentérico es una entidad clínica rara, que debe ser considerado como uno de los diagnósticos diferenciales de una masa abdominal con efecto compresivo. El diagnóstico se basa principalmente en el examen clínico y los hallazgos imagenológicos. La escisión quirúrgica temprana es el pilar del tratamiento; el abordaje laparoscópico o abierto depende de las características clínicas y la experiencia del cirujano.

Background. Teratomas are neoplasms that arise from pluripotent germ cells, derived from two or more layers of germ cells. They are classified as mature tumors (cystic or solid), which contain well-differentiated tissues, or as immature tumors, which contain immature and embryonic structures. Its most frequent location is the female and male gonads; the mesenteric location is rare and approximately 40 cases have been described in the world literature. Within the diagnostic and therapeutic approach, computed tomography and magnetic resonance imaging are used to characterize the lesion, assess intra-abdominal extension and the relationship with other structures. The diagnosis must be confirmed by histopathological examination. Clinical case. A 56-year-old female patient with a history of infiltrating ductal carcinoma of the left breast in remission. In follow-up studies, incidental abdominal tomography finding of an abdominopelvic lesion dependent on the mesentery at the level of the mesogastrium, smooth contours with fat-liquid level. Extension studies with negative tumor markers. Results. Due to high clinical and imaging suspicion of teratoma, the patient was taken to resection of the lesion. Histopathological examination confirmed the diagnosis of mature cystic teratoma of the mesentery. Conclusion. Mesenteric teratoma is a rare clinical entity and is considered one of the differential diagnoses of an abdominal mass with a compressive effect. Diagnosis is mainly based on clinical examination and imaging findings. Early surgical excision is the mainstay of treatment; laparoscopic or open approach depends on the clinical characteristics and the experience of the surgeon.

Presentación atípica de teratoma quístico maduro gigante en una paciente adolescente: a propósito de un caso / Atypical presentation of a giant mature cystic teratoma in an adolescent patient: A case report

Introducción: El teratoma quístico maduro es un tipo de tumor derivado de las células germinales que aparece en pacientes en edad fértil. La edad más frecuente de aparición de este tipo de tumores es entre los 20 y40 años.Caso clínico: Se presenta el caso de una paciente adolescente de 18 años con masa abdominal gigante de crecimiento abrupto cuya presentación fue atípica dado el tamaño de esta, el cual se manifestó con dolor abdominal agudo.Tratamiento: Se realiza resección de la masa la cual confirma el diagnóstico histopatológico de teratoma quístico maduro.Conclusión: Este tipo de patologías rara vez se presentan con un crecimiento tan exagerado como el caso de la paciente en mención, y la resolución quirúrgica sigue siendo el gold estándar en cuanto al tratamiento.Palabras clave:DeCS: Teratoma, Células germinativas embrionarias, Adolescente, Neoplasias

Introduction: Mature cystic teratoma is a type of tumor derived from germ cells that appears in patients of childbearing age. The most common age at which this type of tumor appearsis 20 to40.Clinical case: The case of an 18-year-old adolescent patient with a giant abdominal mass of abrupt growth is presented, whose presentation was atypical given its size, which manifested with acute abdominal pain Treatment: Amass resection confirmedthehistopathological diagnosis of mature cystic ter-atoma.Conclusion: This type of pathology rarely presents with growth as exaggerated as in the case of the patient mentioned. Surgicalresolution continues to be the gold standard in terms of treatment

Isolation,cultivation and identification of human embryonic fibroblasts and expressions of cytokines essential for growth of human embryonic germ cells in vitro / 吉林大学学报(医学版)

Objective To isolate,cultivate and identify the human embryonic fibroblasts(hEFs) derived from the gonadal ridges and dorsal mesenteries of human embryos,and to detect the expression by hEFs of cytokines crucial for the growth of human embryonic germ cells(hEG) in vitro.Methods The hEFs were isolated by enzyme digestion from gonadal ridges and dorsal mesenteries of 5-to 9-week old human embryos.The cells were then cultivated.The biologic characteristics(morphology,growth characteristics and cell cycle) of these cells were also studied.The reverse transcription-polymerase chain reaction(RT-PCR) was used to seek the expressions of a specific fibroblast marker,prolyl 4-hydroxylase ?,and a specific marker of epithelial cells,cytokeratin-4,in the cells.The expressions of cytokines essential for the growth of hEG,namely basic fibroblast growth factor(bFGF) and leukemia inhibitory factor(LIF),were also examined by RT-PCR.Results The hEFs were successfully isolated and cultivated from gonadal ridges and dorsal mesenteries of human embryos.They could be passaged beyond the 25th generation.The biologic characteristics of the cells did not change,even in high-passage cells or frozen-thawed cells.The cells expressed prolyl 4-hydroxylase ?, but not cytokeratin-4,which was similar to the fibroblasts.The cultured cells expressed bFGF and LIF.Conclusion The hEFs derived from gonadal ridges and dorsal mesenteries of human embryos are successfully isolated and cultivated,and the cells express the cytokines essential for the growth of hEG in vitro.

Isolation,culture and primary identification of human primordial germ cells / 第三军医大学学报

Objective To explore how to isolate and culture human primordial germ cells(PGCs).Methods Human embryonic fibroblasts(HEFs) isolated from embryos at 2 to 3 months of age received a radiation of 60Co ?-ray and then served as feeder layer cells.Cells collected from trypsinized human embryonic gonadal ridges and dorsal mesenteries(5 to 9 weeks post-fertilization) were cultured on HEF feeder layers in the medium with recombinant human leukemia inhibitory factor(LIF),recombinant human basic fibroblast growth factor(bFGF) and forskolin.Histochemical and immunocytochemical assays were used to identify the stage specific embryonic antigen-1and 4(SSEA-1/4) of the cultured cells.Reverse transcription polymerase chain reaction(RT-PCR) was used to identify the expressions of specific genes,including Oct-4,Ifitm-3,stella,Mvh and DAZL.Embryonic bodies were cultured as while.Results The collected cells were growing on the feeder layer and formed a typical nestlike multicellular colonies.The cells showed diploid chromosome in karyotype analysis and expressed SSEA-1/4 and specific genes,Oct-4,Ifitm-3,stella,Mvh and DAZL,indicating that the cells were PGCs.When cultured in hanging drop,the PGCs developed into embryonic bodies,showing multipotential ability.Conclusion Human PGCs can be isolated from genital ridges and dorsal mesenteries of embryos and cultured in vitro on HEF feeder layer.The formation of the embryonic stem cell colony can be observed,and the cells cultured by this method is confirmed to be embryonic germ cells.

Research Progress and Future Perspectives in Animal Stem Cell Research

Researches on manipulating pluripotent stem cells derived from blastocysts or primordial germ cells (PGCs) have a great advantage for developing innovative technologies in various fields of life science including medicine, pharmaceutics, and biotechnology. Since their first isolation in the mouse embryos(1), stem cells or stem cell-like colonies have been continuously established in the mouse of different strains(21), cattle(2, 3), pig(4, 5), rabbit(6, 7), and human(9). However, full-term development originated from established pluripotent cells, which is an absolute criterion for proving cell pluripotency and differentiation, has only been reported in the mouse(22). Due to technical difficulties, no further progress has been made in the establishment of animal embryonic stem (ES) cell line. Alternatively, the use of embryonic germ (EG) cells was selected to establish an animal stem cell line. EG cells also have pluripotent characteristics, which were proven by morphological assay, intracellular alkaline phosphatase activity, and reactions with cell surface-specific markers. The finding of Labosky et al.(23) on germline chimera development after transfer to embryos clearly proved the pluripotency of EG cells and their similar characteristics with ES cells. Avian transgenesis has an unlimited value in biotechnology industry, since its applicability as a bioreactor has proven to be greater than that of mammalian species(24). In the chicken, EG cells can be extensively utilized instead of ES cells for efficiently inducing transgenesis mediated by germline transmission. Recently, PGCs collected from the embryonic gonad were suggested to be useful in establishing avian stem cells. Technical feasibility and applicability of gonadal PGCs (gPGCs) to germline chimera production were also confirmed(25) and a gPGC culture system to establish EG cells was subsequently developed(15).

GROWTH OF HUMAN EMBRYONIC GERM CELLS ON HUMAN EMBRYONIC FIBROBLASTS / 解剖学报

Objective To investigate the isolation, purification and culture methods of human embryonic germ cells (EGCs) on feeder layer cells of human embryonic fibroblasts. Methods Primordial germ cells(PGCs) from the genital ridges of 6-11 weeks(post fertilization) human embryos were cultrued on feeder layer cells of human embryonic fibroblasts(HEFs) which were isolated from the 3-4 month embryos and routinely cultured for over 25 passages. The medium composed of growth factors and differentiation inhibitory factors. The cultures were analyzed with the expression of alkaline phosphatase, immunologic markers (SSEA-1,SSEA-4) and the transcription factor Oct-4 that have been used to routinely to characterize EGCS. Results A large-scale EG cells were obtained and meintained on feeder layers for over 8 passages. The cell surface marker showed that the EGCs possess high levels of AP activity. EGCs colonies stained strongly for SSEA-4,SSEA-1 and they expressed the transcription factor Oct-4.Conclusion EGCs have potential to maintain long term proliferation and undifferentiation state on human embryonic fibroblasts in vitro.;

THE EXPRESSION OF SSEA-1 AND OCT-4 ON HUMAN EMBRYONIC GERM CELLS / 解剖学报

Objective To culture human embryonic germ cells in vitro and identify them by observing the expression of the surface markers SSEA-1 and Oct-4. Methods The gonadal ridges and mesenteries of human embryos at 5～9 weeks post-fertilization were isolated and then cultured in vitro.Flow cytometry and immunocytochemistry were applied to detect whether the cells cultured express SSEA-1 and Oct-4.Immunohistochemistry was also carried out to observe the expression of SSEA-1 on the PGCs which locate in the gonadal ridge. Results Both the cells and the cellular colonies cultured in vitro expressed SSEA-1 and Oct-4.The immunohistology study of gonadal ridges also showed that there were many PGCs which were SSEA-1 positive in it.Conclusion The cells we obtained through tissue culturing are undifferentiated human embryonic germ cells,which originate from hPGCs.