肝成熟性囊性畸胎瘤合并腺癌1例报道并文献复习

Adult liver mature cystic teretoma with malignant transformation: a case report and review of literature

目的 报道 1例罕见的成人肝成熟性畸胎瘤腺癌变的临床病理特点。方法 进行临床病理和免疫组化分析 ,并结合文献讨论其诊断与鉴别诊断。结果 肝肿瘤大小为 7cm× 4 5cm× 4cm ,切面部分囊性 ,部分实性。组织学上具有上皮、肌肉、软骨、脑组织等。部分腺上皮发生腺癌变。免疫组化示癌变组织CEA、p5 3、nm2 3、CK2 0、MDR、GST π等强 (+)。结论 成人肝成熟性囊性畸胎瘤非常罕见 ,腺癌变文献上还未见报道。癌细胞p5

Purpose To report clinicopathologic features of a rare case of adult liver cystic mature teretoma with carcinomatous change. Methods To analyze this rare case of liver cystic mature teretoma with malignant transformation,we examined clinicopathologic changes, and immunohistochemical findings, respectively, with review of the literature. Results A 33-year old female presented a liver occupied lesion and she had history of ovary immature teretoma 17 years ago and mediastinal mature teretoma 12 years ago. The liver tumor measured 7?cm×4.5?cm×4?cm in diameter. On cut surface, there were both cystic and solid areas. Histologically, the tumor composed of mature benign epithelial, lipocyte, muscle, cartilage, and brain tissues. In local area, the gland epithelium showed atypia and transition to the malignant mucous epithelium, which was strongly positive reacted with antibodies of CEA, p53, nm23, and CK20. Conclusion Liver primary teretoma is a very rare liver tumor, and there are only about 30 cases reported in literature. To best of our knowledge, this is the first case report of adult liver cystic mature teretoma with malignant transformation in the literature. Immunohistochemically, the carcinomatous transformation cells are related to the mutation of p53 in this case.