卵巢畸胎瘤的CT诊断（附21例分析）

笔者分析了２１例卵巢畸胎瘤的ＣＴ表现。囊性畸胎瘤表现为脂肪密度肿块；囊实性畸胎瘤伴有结节状软组织密度影，可伴有钙化和骨化。并对卵巢畸胎瘤的ＣＴ诊断与鉴别诊断作了简要的讨论。

Characteristics, diagnosis and treatment of hepatic metastasis of pure immature ovarian teratoma

Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment.Methods Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively,Results All of the hepatic metastatic tumors were located on the surface of the liver. 61.1％ (11/18) of them were clinical stage Ⅲ and 44.4％ (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7％ (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2％ (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4％ (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8％ (14/ 18), and mortality rate was 22.2％. The 5- and 10-year-survival rate was 55.6％ (10/18) and 38.9％ (7/18), respectively. The rate of loss in follow-up was 22.2％ (4/18) and 38.9％ (7/18), respectively, and one patient has survived for more than 17 years.Conclusions The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients.

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.

Retrospective analysis of 67 consecutive cases of pure ovarian immature teratoma

OBJECTIVE: To investigate the development regularity, treatment methods and prognosis of ovary immature teratoma (POIT). METHODS: Sixty-seven patients with POIT, admitted from 1958 to 1998, were retrospectively analyzed. There were 31 patients with stage I, 4 with stage II, 2 with stage III and 1 with stage IV lesions. Twenty-seven patients had recurrences and 2 had distant metastases. Unilateral adnexectomy was performed for stage I lesions. From the 1980s, this was followed by four-cycles of combination chemotherapy (VAC, PVB or BEP x 3 cycles) as post-operative adjuvant therapy. Combined chemotherapy and multiple operations were performed for advanced and recurrent lesions. RESULTS: The overall survival rate was 75% (50/67). However, there was a remarkable difference in the results from the various periods. From 1958 to 1983, the 5-year survival rate was 40% (6/15), and it was raised to 79% (26/33) from 1984 to 1993. In the period 1994 to 1998, 95% (18/19)of patients were rescued. Thirty-five patients who had early lesions (stage I and II) had a 5-year survival rate of 91.4% (32/35). Thirty-two patients with recurrent or advanced lesions had a 5-years survival rate of 56% (18/32). There were 8 patients with grade III tumors and their 5-year survival rate was only 25% (2/8). The chief prognostic factors for this disease are clinical stage, pathological grade and adequate treatment. CONCLUSION: POIT is a potentially curable disease in today's practice. It is characterized by the fact that recurrent tumors may be converted back to mature ones as time goes on. With chemotherapy, these is a good opportunity to rescue those patients with recurrent tumors. At present, treatment of POIT gives the most satisfactory results among all malignant ovarian germ cell tumor types. Tests of serum specific tumor markers (CA19-9, AFP, CA125, CEA) performed preoperatively or before chemotherapy and during follow-up have been found helpful in the evaluation of prognosis.

Retrospective analysis of 67 consecutive cases of pure ovarian immature teratoma

To investigate the development regularity, treatment methods and prognosis of ovary immature teratoma (POIT) Methods Sixty seven patients with POIT, admitted from 1958 to 1998, were retrospectively analyzed There were 31 patients with stage Ⅰ, 4 with stage Ⅱ, 2 with stage Ⅲ and 1 with stage Ⅳ lesions Twenty seven patients had recurrences and 2 had distant metastases Unilateral adnexectomy was performed for stage Ⅰ lesions From the 1980s, this was followed by four cycles of combination chemotherapy (VAC, PVB or BEP×3 cycles) as post operative adjuvant therapy Combined chemotherapy and multiple operations were performed for advanced and recurrent lesions Results The overall survival rate was 75% (50/67) However, there was a remarkable difference in the results from the various periods From 1958 to 1983, the 5 year survival rate was 40% (6/15), and it was raised to 79% (26/33) from 1984 to 1993 In the period 1994 to 1998, 95% (18/19)of patients were rescued Thirty five patients who had early lesions (stage Ⅰ and Ⅱ) had a 5 year survival rate of 91 4% (32/35) Thirty two patients with recurrent or advanced lesions had a 5 years survival rate of 56% (18/32) There were 8 patients with grade Ⅲ tumors and their 5 year survival rate was only 25% (2/8) The chief prognostic factors for this disease are clinical stage, pathological grade and adequate treatment Conclusion POIT is a potentially curable disease in today’s practice It is characterized by the fact that recurrent tumors may be converted back to mature ones as time goes on With chemotherapy, these is a good opportunity to rescue those patients with recurrent tumors At present, treatment of POIT gives the most satisfactory results among all malignant ovarian germ cell tumor types Tests of serum specific tumor markers (CA19 9, AFP, CA125, CEA) performed preoperatively or before chemotherapy and during follow up have been found helpful in the evaluation of prognosis