摘要
Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment.Methods Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively,Results All of the hepatic metastatic tumors were located on the surface of the liver. 61.1％ (11/18) of them were clinical stage Ⅲ and 44.4％ (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7％ (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2％ (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4％ (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8％ (14/ 18), and mortality rate was 22.2％. The 5- and 10-year-survival rate was 55.6％ (10/18) and 38.9％ (7/18), respectively. The rate of loss in follow-up was 22.2％ (4/18) and 38.9％ (7/18), respectively, and one patient has survived for more than 17 years.Conclusions The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients.
目的 总结单纯性卵巢未成熟型畸胎瘤肝脏周围复发的特点 ,探讨其正确诊断和治疗方案。方法 采用回顾性分析方法 ,对 18例肝脏周围复发的单纯性卵巢未成熟型畸胎瘤患者的临床分期、手术、化疗以及其原发、复发肿瘤的病理 ,结合长期随诊结果进行综合分析。结果 本组患者平均发病年龄为 2 4 8岁 ,初次手术 38 8%患者行单侧附件切除术 ,6 1 1%为临床Ⅲ期 ,4 4 4 %肿瘤病理分级为G1级 ;单纯性卵巢未成熟型畸胎瘤肝脏周围复发率为 2 8 1% ,其中接受正规化疗组患者肝脏周围复发率为 16 7% ,未行正规化疗组肝脏周围复发率为 31 2 % ;辅助诊断准确率较低 ;肝动脉插管化疗对肿瘤生长控制无效。单纯性卵巢未成熟型畸胎瘤肝脏周围复发患者随诊时间为平均 2 0 9个月 ,手术切除率为 94 4 % ,转移瘤直径 <15cm者手术并发症少 ,患者三年生存率为 77 8% ,失访率 0 0 % ;五年生存率为 55 6 % ,失访率为2 2 2 % ;十年生存率为 38 9% ,失访率为 38 9%。结论 单纯性卵巢未成熟型畸胎瘤的肝脏复发部位为肝脏周围表面 ;正规化疗是预防其肝脏周围复发的重要措施 ,但不能抑制其生长。肝动脉插管化疗的方法是错误的。适时手术可减少并发症 。
