原发性肝脏囊性畸胎瘤合并恶性黑色素瘤1例临床病理观察

Primary cystic teratoma of liver with malignant melanoma: a clinicopathological analysis of one case

目的肝脏成熟型囊性畸胎瘤极为罕见,发生恶性转化的仅见少数个例报道,合并恶性黑色素瘤未见文献报道。本文报道首例肝脏原发性成熟型囊性畸胎瘤合并恶性黑色素瘤的病例,并进行文献复习。方法通过组织病理学、免疫组化及影像学的方法进行诊断,查阅中外文献并进行复习。结果肉眼见为囊性肿物,显微镜下呈典型的成熟型囊性畸胎瘤病理改变,囊内局部区域见恶性黑色素瘤细胞呈浸润性生长。免疫组化黑色素瘤标记性抗原呈强阳性反应,影像学显示肝脏呈囊性畸胎瘤改变。结论本例肝脏成熟型囊性畸胎瘤合并恶性黑色素瘤,为首次报道的极罕见病例,其病理学特点和发生于卵巢的囊性畸胎瘤合并恶性黑色素瘤的病例相似,需和转移性恶性黑色素瘤加以鉴别。

Objective Mature cystic teratomas of liver are extremely rare,malignant transformation of this tumor has been reported only in a few cases,and one complicated with malignant melanoma has not been reported in the literature.We report the first case of primary mature cystic teratoma of liver with malignant melanoma,with literature review.Methods The histopathologic changes,immunohistochemical findings and imaging were analyzed in a case of cystic teratoma of liver with malignant melanoma,with review of Chinese and foreign literature.Results Gross findings showed it was a cystic neoplasm.Microscopic findings showed typical pathological changes of mature cystic teratomas with malignant melanoma cells in the local area of the cyst.Specific melanoma antigens were strongly positive in tumor cells by immunohistochemistry.Imaging showed a cystic teratoma change of the liver.Conclusions The extremely rare case of mature cystic teratoma of liver with malignant melanoma is reported for the first time.Its pathological characteristics are similar to a cystic teratoma with malignant melanoma occurred in the ovary.It is necessary to differentiate it from metastatic malignant melanoma.