卵巢原发性恶性黑色素瘤1例及文献复习

Primary malignant melanoma of ovary—A case report and literature review

目的 探讨卵巢原发性恶性黑色素瘤的临床病理特征 ,及其与卵巢转移性肿瘤的鉴别诊断。方法 对 1例原发于卵巢囊性畸胎瘤的恶性黑色素瘤标本 ,通过光镜及免疫组化等方法进行病理组织学观察。结果 组织学特征为 :肿瘤细胞大小不等 ,形态多样 ,界限不清 ,呈透明细胞和 /或印戒细胞样 ;瘤细胞内外可见一些粗大的黑色素颗粒 ,瘤组织内血管较多 ,核分裂象多见 ,>10个 / 10HPF。免疫组化HMB45、Vimentin及S 10 0蛋白肿瘤细胞呈阳性表达。结论 卵巢原发性恶性黑色素瘤来源于卵巢成熟的囊性畸胎瘤恶变 ,是一种罕见的卵巢肿瘤。根据其组织学和病理形态学特征 ,结合腹部包块和囊性畸胎瘤等临床表现 ,可以作出明确的病理诊断。

Objective To study the clinical pathological characteristics of primary ovarian malignant melanoma and its differential diagnosis from metastatic tumors of ovary. Methods A case of primary malignant melanoma arising from a cystic teratoma of the ovary was studied by histopathologcal observation and immunohistochemical staining. Results The histological characteristics of the tumor are that the tumor cells vary in size and shape and have vague boundary, and showed clear cytoplasm and/or signet ring morphology.Some thick melanin grains can be seen in or out of the cells, Numerous blood vessels and mitotic figures(>10/10HPF) are present Immunohistochemical stainings of HMB45, vimentin and S-100 protein are positive in the tumor cells. Conclusions Primary ovarian malignant melanoma arising from a mature cystic teratoma with malignant change, was a rare neoplasm. Based on the histopathological characteristics and clinical manifestations a definite pathological diagnosis of the tumor can be made.