育龄女性成熟囊性畸胎瘤鳞癌变1例及文献复习

Squamous Cell Carcinoma Arising from Mature Cystic Teratoma of the Ovary in Women of Reproductive Age: A Case Report and Literature Review

目的探讨发生于育龄期女性成熟囊性畸胎瘤(MCT)鳞状细胞癌变的疾病特点、治疗方式和预后,提高临床医师对疾病的认识。方法回顾性分析2017年3月10日大连医科大学附属大连市妇幼保健院收治的1例发生于育龄期女性MCT鳞癌变的病例特点、治疗方式及预后,并结合相关文献进行讨论。结果该患者29岁,因畸胎瘤破裂行手术治疗,病理提示畸胎瘤鳞癌变,行保留生育功能的卵巢癌分期术,术后辅以TC(紫杉醇和卡铂)方案化疗6个疗程,随诊15个月未见复发及并发症。结论育龄期女性MCT鳞癌变发病罕见,畸胎瘤病史较长、肿瘤破裂、组织界限不清需警惕癌变可能,必要时术中冰冻协助诊断。Ⅰc期有生育要求的年轻患者,可行保留生育功能的分期手术,术后积极辅助化疗以TC方案为主,并严密随诊。

Objective To investigate the characteristics,treatments and prognoses of squamous cell carcinogenesis of mature cystic teratoma in women of reproductive age,and improve clinicians′understanding of the diseases.Methods A case of mature teratoma squamous cell carcinoma in reproductive age was analyzed and literature review was done.Results The patient(aged 29 years)was treated by surgery because of teratoma rupture.Teratoma squamous cell carcinoma was found by pathology,and ovarian cancer staging surgery was performed with reserved fertility,and 6 courses of chemotherapy with TC(taxinol and carboplatin)regimen were used after operation.No recurrence and complications were found during 15 months follow-up.Conclusion Mature teratoma squamous cell carcinoma is rare in women of reproductive age.A longer teratoma history,tumor rupture and unclear tissue boundaries may indicate the possibility of canceration.Intraoperative freezing may be necessary to assist diagnosis.Young patients atⅠc stage with fertility requirements may undergo staged surgery with fertility preservation.The main adjuvant treatment after operation is TC regimen and strict follow-up.