17例卵巢未成熟畸胎瘤临床病理观察并文献复习

Clinicopathological Observation and Literature Review of 17 Cases of Immature Teratoma of Ovary

目的:卵巢未成熟畸胎瘤(immature teratoma)是一种少见的发生于卵巢的恶性肿瘤,本研究旨在探讨卵巢的临床特征、组织病理学、免疫表型及鉴别诊断。方法:收集济宁医学院附属医院2011年8月~2022年5月收治的17例未成熟畸胎瘤,分析其临床病理学特征及免疫表型并文献复习。结果:患者(17例)平均发病年龄为25.4岁,首次就诊原因6例为腹部包块,11例为腹胀伴有不同程度的腹痛。巨检:3例为实性肿物,14例为囊实性肿物。组织学:存在原始的神经外胚层组织或原始神经管。免疫组化:SALL-4表达在未成熟的神经成分,且Ki-67增值指数较高,部分患者不成熟的胃肠型腺体表达AFP。结论:卵巢未成熟畸胎瘤是罕见地发生于卵巢的生殖细胞肿瘤,好发于中青年女性,镜下未成熟神经上皮量决定肿瘤的病理分级。

Background and Objective: The immature teratoma is a rare malignant tumor of the ovary. The aim of this study is to investigate the clinical features, histopathology, immunophenotype, and differen-tial diagnosis of immature teratoma. Methods: Seventeen cases of immature teratoma were col-lected at the Affiliated Hospital of Jining Medical University, China, from August 2011 to May 2022. The clinicopathological features and immunophenotypes were analyzed, and the literature was re-viewed. Results: The average age of onset was 25.4 years. Abdominal mass was the first complaint in 6 cases and abdominal distension with varying degrees of abdominal pain in 11 cases. On giant examination, 3 cases were solid masses and 14 cases were cystic-solid masses. Histology: Primitive neuroectodermal tissue or primitive neural tube was present. Immunohistochemically, SALL-4 was expressed in immature neural components with a high Ki-67 proliferation index. AFP was ex-pressed in immature gastrointestinal glands of some patients. Conclusions: Ovarian immature ter-atoma is a rare germ cell tumor of the ovary, which mainly occurs in young and middle-aged women. The amount of immature neuroepithelium under the microscope determines the pathological grade of the tumor.