卵巢成熟性囊性畸胎瘤伴中-低分化鳞癌1例并文献复习

目的:探讨卵巢成熟性囊性畸胎瘤伴鳞状细胞癌的病理学诊断及鉴别诊断。方法:分析1例卵巢成熟性囊性畸胎瘤伴鳞状细胞癌临床资料、影像学特征及病理学特征并进行文献分析。结果:巨检见灰白灰褐色囊状肿物,18cm×11cm×7cm,囊内含脂质与毛发,可剥离,囊壁较光滑,未见液体及黏液成分。囊内一侧见4cm×3cm灰白色实性区域,切面灰白色、质脆。镜下肿瘤囊壁内衬鳞状上皮,囊壁内见皮脂腺及毛囊;可见散在的核大深染的呈弥漫排列的细胞,核仁不明显,部分细胞呈梭型,多次取材发现小片状分化的鳞状细胞癌癌区,其中可见细胞内角化、细胞间桥及角化珠。免疫组化染色结果:CK5/6及PCK:恶性肿瘤细胞阳性表达。病理诊断:卵巢成熟性囊性畸胎瘤伴中-低分化鳞状细胞癌。结论:卵巢成熟性囊性畸胎瘤伴鳞状细胞癌是一种少见的高度恶性肿瘤,患者年龄及绝经年龄、肿瘤的大小、规范的病理学检查及特征性的免疫组化标记有助于其病理学诊断及鉴别诊断。

Analysis of 20 mature ovarian cystic teratoma cases in postmenopausal women

Objective To study the incidence of malignant change, diagnosis and management of mature cystic teratomas in postmenopausal women.Methods Twenty cases of mature cystic teratoma in postmenopausal women admitted to our hospital between January 1977 and January 1997 was retrospectively reviewed and evaluated.Results The number of postmenopausal patients with mature cystic teratoma (20) accounted for 7.6% of the total number of patients with benign ovarian teratomas (263). There were 3 cases of malignant change, which were squamous carcinoma, carcinosarcoma, and digestive gland epithelial carcinoma. The incidence of malignant change was 15%.Conclusion In postmenopausal women, mature ovarian cystic teratoma should be treated as lowly malignant and should be paid much attention.