卵巢非妊娠性绒癌临床病理观察

Nongestational ovarian choriocarcinoma: a clinicopathological analysis of two cases

目的探讨卵巢非妊娠性绒癌的临床病理学特征。方法观察2例卵巢非妊娠性绒癌的临床表现、组织学形态及免疫组化特征并复习文献。结果 2例患者均为13岁女童,肿瘤均位于左侧卵巢,瘤组织中可见各型滋养细胞成分,呈巢状、筛状、乳头状排列,伴明显出血坏死;其中1例伴右侧卵巢环状小管性索瘤,免疫组化显示2例绒癌均hCG和CK(+),伴发的环状小管性索瘤CD56和CD99(+)。结论卵巢非妊娠性绒癌为罕见的高度恶性的生殖细胞肿瘤,伴发环状小管性索瘤更为罕见。非妊娠性绒癌易早期转移,预后极差。

Objective To analyze the clinicopathological teatures ot nongestational ovarian choriocarcinoma. Methods The histopathologic, immunohistochemical and clinical festures of two cases of nongestational ovarian choriocarcinoma were studied, with review of the literature. Results Both patients were 13-year old girls, with a tumor mass in their left ovaries. The growth patterns of cells included cribriform, papillary and tufts in the background of hemorrhage and necrosis. One of the patients was found to have a sex cord tumor with annular tubules （SCTAT） in her right ovary. The co-occurrence of these two types was firstly reported in literature. Immunohistochemically, the tumor cells of ehoriocarcinoma were positive for hCG, CK and those of SCTAT positive for CD56 and CD99. Conclusion Nongestational ovarian choriocarcinoma is an extremely rare germ cell tumor with high grade malignancy, and those with STCAT is even rarer. Nongestational choriocareinoma has early metastasis and poor prognosis.