恶性卵巢甲状腺肿的诊治进展

Update on diagnosis and treatment of malignant struma ovarii

卵巢甲状腺肿是一种少见的单胚层畸胎瘤。恶性卵巢甲状腺肿(MSO)占卵巢甲状腺肿5%～10%,多指符合恶性甲状腺肿瘤诊断标准或有远处侵袭转移表现的卵巢甲状腺肿。恶性卵巢甲状腺肿缺乏特异性临床表现,多因盆腔包块就诊,绝大多数为单侧。传统的影像学诊断卵巢甲状腺肿的价值有限。乳头状癌是MSO主要的病理类型,约占70%。由于其罕见性,目前无统一的治疗方案。治疗以手术为主,复发或转移患者可考虑全甲状腺切除+I131治疗。建议术后随访10年以上,总体预后良好。

Struma ovarii(SO)is a rare monodermal differentiated ovarian teratoma.Malignant struma ovarii(MSO)refers to cases demonstrating local invasion,distant metastases or morphologic features of thyroid carcinoma on histological analysis,accounting for 5%~10%of SO.Currently,there are no typical clinical manifestations and laboratory indicators of MSO.Most cases of MSO are presented to the department of gynecology with complaints of pelvic mass,and most of them are unilateral.Traditional image examinations have limited value in the diagnosis of MSO.Papillary carcinoma is the main pathological type of MSO,accounting for about 70%.Due to its rarity,optimal management has not been defined.Surgery is the first-line treatment.When recrudescence or distant metastases is present,total thyroidectomy combined with I 131 ablation is warranted.A follow-up of at least ten years is necessary.The prognosis after surgery is usually good.