卵巢无性细胞瘤伴绒毛膜促性腺激素显著升高1例

卵巢无性细胞瘤是一种中度恶性的卵巢生殖细胞肿瘤,好发于年轻女性,临床发病少见,手术+铂类为主的联合化疗使该病有良好的生存预后及妊娠结局.单纯卵巢无性细胞瘤无内分泌功能,临床检测绒毛膜促性腺激素(HCG)一般为阴性,仅6％～8％含有小簇合体滋养细胞而使HCG呈低反应.本文通过分析1例单纯卵巢无性细胞瘤伴HCG值高达549...     

卵巢无性细胞瘤19例临床与病理分析

目的 研究卵巢无性细胞瘤的临床与病理特征以及预后情况。方法 回顾性分析19例卵巢无性细胞瘤临床与病理资料，并随访其预后。结果 术后存活13例(随访9～30年，均为临床Ⅰ期)，术后1年内死亡4例(临床Ⅱ期2例，其中1例合并卵黄囊瘤，另1例合并梅格斯综合征，另临床Ⅲ期、Ⅳ期各1例)，失访2例。结论 早期单纯型无性细胞瘤预后好，晚期混合型无性细胞瘤并临床分期高者预后差。     

卵巢生殖细胞肿瘤的临床统计分析

本文报道近十年来本院收治的卵巢生殖细胞肿瘤１７２例，占同期卵巢肿瘤的２５．５％。其中成熟型畸胎瘤１６２例，卵巢甲状腺肿１例，未成熟型畸胎瘤５例，成熟型畸胎瘤恶变２例，无性细胞瘤１例，混合型生殖细胞瘤（卵黄囊瘤合并成熟型畸胎瘤）１例。本组资料显示：成熟型畸胎瘤合并妊娠者对围产儿无明显不良影响，本文并讨论了未成熟型畸胎瘤的治疗原则。     

两性畸形合并卵巢无性细胞瘤1例

两性畸形合并卵巢无性细胞瘤临床少见,如对此疾病及其关系认识不足,易延误诊断及治疗,现将1例报告如下.     

卵巢无性细胞瘤的放射治疗

卵巢无性细胞瘤的放射治疗浙江省肿瘤医院高永良卵巢无性细胞瘤对放射治疗非常敏感。手术后放疗的疗效奇佳［１］。几十年来术后放疗一直作为卵巢无性细胞瘤的传统治疗方式。但放疗有其一定的局限性及并发症，如放射性膀胱炎、放射性直肠炎，盆腔纤维化及瘘等。放疗对生育...     

儿童卵巢无性细胞瘤一例并文献复习

儿童卵巢无性细胞瘤在临床较少见,结合病史及辅助检查综合考虑,手术在儿童卵巢无性细胞瘤中是首选方法。随着综合治疗模式的发展,需要考虑手术治疗后对于儿童生育力的保护及卵巢恶性肿瘤的管理。报告1例12岁儿童卵巢无性细胞瘤病例,患者因下腹胀痛首次就诊于延安大学附属医院儿科,发现盆腔包块后就诊于妇科,肛门指诊示盆腔偏右侧可触及约7.0 cm×6.0 cm包块,质中,边界尚清,活动可,相关肿瘤标志物（甲胎蛋白、糖类抗原125）略升高,剖腹探查行术中冰冻病理所示考虑左侧卵巢良性病变,右侧卵巢恶性病变,故行右侧附件切除术+左侧卵巢囊肿剥除术,术后给予辅助化疗同时给予戈舍瑞林去势保护卵巢功能治疗。现已随访11个月,患者月经规律,无特殊不适。通过回顾性分析儿童卵巢无性细胞瘤诊治过程及特点,以期提高临床医师对该病诊断、治疗及管理的认识。     

足月妊娠合并巨大卵巢无性细胞瘤1例

足月妊娠合并巨大卵巢无性细胞瘤１例山东济阳县人民医院妇科（２５１４００）翟敏赵云英患者２７岁，住院号３５４８６，因产后３６小时，腹部仍如足月妊娠状，于１９９０年４月３日入院。３６小时前在家足月顺娩一女婴，产后腹部仍膨隆，认为双胎来我院。患者孕前及孕期...     

卵巢无性细胞瘤10年生存率随访结果及分析

目的 探讨卵巢无性细胞瘤的治疗与预后。方法 ３４例卵巢无性细胞瘤均采用手术加放疗。结果 ３４例病例中,Ⅰ、Ⅱ期１８例１０年生存率１００％,Ⅲ期１５例１０年生存率为９３．０％,Ⅳ期１例生存１５个月,总生存率为９４．１％,结论 卵巢无性细胞瘤属恶性肿瘤,对放疗及化疗均十分敏感,能获得较佳治疗效果。但应加强随访,随访可采用血乳酸脱氢酶及其同工酶作为判断该肿瘤浸润转移倾向的特异性肿瘤标志物。     

卵巢恶性生殖细胞瘤的诊断与血清标记物诊断的价值

卵巢恶性生殖细胞瘤的诊断与血清标记物诊断的价值４３００３０同济医科大学同济医院顾美皎卵巢恶性生殖细胞瘤虽有共同的临床特征，但每一类型的肿瘤临床所见不尽相同，故临床诊断时应予鉴别，力求术前及术中正确诊断，以便指导临床制订治疗方案。一、无性细胞瘤（一）临...     

卵巢无性细胞瘤伴少量合体滋养叶细胞和腺样卵黄囊细胞一例及文献复习

无性细胞瘤（dysgerminoma）是卵巢比较少见的肿瘤,占原发卵巢肿瘤的1％,其中3％～5％出现合体滋养叶细胞分化,少部分出现卵黄囊成分。腺型卵黄囊是卵黄囊瘤中比较少见的形态,易引起误诊。在此报道一例卵巢无性细胞瘤伴少量合体滋养叶细胞及腺样卵黄囊细胞,并结合文献分析其临床病理特征。     

妊娠合并卵巢肿瘤及瘤样病变58例临床分析

目的探讨妊娠合并卵巢肿瘤及瘤样病变患者的临床特征和处理对策。方法回顾性分析2009年1月至2010年12月福建省妇幼保健院收治的58例经手术病理诊断的妊娠合并卵巢肿瘤及瘤样病变患者的临床资料。结果 58例妊娠合并卵巢肿瘤及瘤样病变患者占同期妊娠的0.24%(58/23756),其中卵巢良性肿瘤及瘤样病变56例(96.6%),卵巢恶性肿瘤2例(3.4%)。妊娠前首次发现者5例(8.6%);孕早期发现者22例(37.9%),孕中期发现者18例(31.0%),孕晚期发现者13例(22.4%);孕早、中期均为超声检查发现,孕晚期均为剖宫产术中发现。56例卵巢良性肿瘤及瘤样病变患者中,50例(89.3%)行卵巢囊肿切除术,6例(10.7%)行附件切除术,随访8～18个月未见复发。2例妊娠合并卵巢恶性肿瘤患者中,1例卵巢浆液性囊腺癌行肿瘤细胞减灭术,术后辅助化疗8个疗程,随访12个月无瘤生存;1例卵巢肿瘤切除术后病理诊断卵巢幼年性颗粒细胞瘤,拒绝再次手术及化疗,术后2个月死亡。58例患者中,妊娠合并卵巢肿瘤蒂扭转行急诊手术8例,发生率为13.8%。58例患者的病理类型为成熟畸胎瘤24例(41.4%),浆液性囊腺瘤22例(37.9%),黄体囊肿10例(17.2%),颗粒细胞瘤1例(1.7%),浆液性乳头状囊腺癌1例(1.7%)。结论超声检查可以诊断和监测妊娠期卵巢肿瘤及瘤样病变,而剖宫产术中常规行双侧附件探查亦很重要。妊娠合并卵巢肿瘤蒂扭转患者以成熟畸胎瘤为最多见。     

卵巢恶性肿瘤保留生育功能治疗52例临床分析

目的:评价卵巢恶性肿瘤保留生育功能手术和化疗对生育和卵巢功能的影响.方法:回顾性分析我院1996年6月至2010年6月卵巢恶性肿瘤行保留生育功能治疗并有完整随访资料的52例患者的临床资料,对其手术、术后化疗及术后月经和妊娠情况进行分析,并对是否行全面分期手术和不同病理类型行保留生育功能治疗后的生存率和复发率相比较,以及是否化疗的妊娠率进行比较.结果:52例患者中生殖细胞恶性肿瘤25例,上皮性恶性肿瘤12例,交界性肿瘤15例.复发3例,其中1例死亡.计划妊娠41例中妊娠成功16例,2例流产.术后化疗的38例患者中,2例化疗期间月经正常,36例在化疗1～2次后停经,但停止化疗后月经恢复.52例患者中行全面分期手术(15例)的生存率和复发率与行附件切除术或卵巢肿瘤剥除术(37例)比较,差异均无统计学意义(P均＞0.05).3种病理类型肿瘤患者保留生育功能治疗后的生存率和死亡率比较,差异均无统计学意义(P＞0.05).化疗患者中的妊娠率与未化疗患者的妊娠率比较,差异也无统计学意义(X2 =0.1186,P＞0.05).结论:卵巢恶性肿瘤保留生育功能治疗是有效和可行的,化疗对卵巢功能可能有影响,但可以逆转.保留生育功能手术以附件切除术或病灶切除术为宜,但结论尚有待大样本量研究及长期随访.     

妊娠合并卵巢恶性肿瘤20例临床分析

目的 探讨妊娠合并卵巢恶性肿瘤的临床特征、处理方法 及预后. 方法 回顾性分析2001年7月至2008年12月在我院诊断及治疗的20例妊娠合并卵巢恶性肿瘤患者的临床及病理资料.结果8年中共诊断妊娠合并卵巢恶性肿瘤20例,发病率0.311/1000次分娩,其中孕期超声诊断14例(70.0%).病理类型中上皮性肿瘤共15例(占75.0%).低度恶性肿瘤(上皮交界性肿瘤和支持间质细胞瘤)共14例(70.0%).20例患者中19例(95.0%)国际妇产科联盟分期1期.16例(80.0%)行保守性手术治疗,4例(20.0%)二次行卵巢癌分期手术.化疗6例(30.0%),其中孕期化疗1例.20例中流产5例;出生新生儿15例,除1例重度窒息死亡外,余4例早产儿及10例足月儿均体健,无后遗症及畸形.随访患者6～80个月,除1例术后4个月死亡,余未见肿瘤复发,生存率95.0%(19/20). 结论 妊娠期妇女的卵巢癌发病率较非妊娠期低,且多为早期,经积极手术及化疗母婴预后大多较好.     

原发性卵巢成熟性囊性畸胎瘤合并甲状腺肿类癌一例报告

卵巢成熟性囊性畸胎瘤合并甲状腺肿类癌是一种罕见的卵巢恶性肿瘤,甲状腺肿类癌来源于生殖细胞肿瘤中的内胚窦瘤,发病率极低,仅占卵巢恶性肿瘤的0.1%。甲状腺肿类癌属于低级别神经内分泌肿瘤,恶性度低,预后良好。诊断中应先排除转移性癌,再与卵巢颗粒细胞瘤、支持细胞瘤、卵巢恶性甲状腺肿等相鉴别。治疗上主要以手术为主,但因该病罕见,尚未建立一套标准的治疗方案。近年来,对于原发性卵巢成熟性囊性畸胎瘤合并甲状腺肿类癌在临床特征、病理及免疫组织化学、治疗等方面均有新的进展,报道1例并就该病的研究进展进行探讨,为后续治疗提供参考。     

妊娠合并卵巢肿瘤的处理

明确妊娠合并卵巢肿瘤的临床特征和处理对策。方法回顾性分析７２例妊娠合并卵巢肿瘤的临床结局。结果妊娠合并卵巢成就畸胎瘤、巧克力囊肿和黄体囊肿的发生率分别为３０．６％、１９．４％和１８．１％。     

Ovarian tumors in pregnancy in the material of the Department of Gynecology and Oncology Collegium Medicum of Jagiellonian University in Cracow

OBJECTIVES: Although ovarian tumors are rare in pregnancy, they constitute a real diagnostic and therapeutic challenge. DESIGN: The aim of the study was to describe pathomorphological and clinical characteristic of ovarian tumor in pregnancy and to review the effects of diagnostics and treatment. MATERIALS AND METHODS: The study included 76 pregnant women treated due to ovarian tumors at Department of Gynaecology and Oncology, Collegium Medicum of Jagiellonian University. The age of patients range from 18 to 41 years (mean age 26 years). Diameter of each tumor was more then 5 cm. RESULTS: The symptoms of the tumors occurred in 25% of patients. Most of them were unilateral (96.05% cases). In 88.16% of cases the tumor diameter did not exceeded 10 cm. 71.05% of tumors were detected in first trimester of pregnancy. More then 50% of cystic tumors, that had not been surgically treated directly after detection disappeared during observation. Most common histological type of operated tumors were teratoma adultum (50%) and corpus luteum cyst. The malignant tumor of ovary was detected in 3.12% of cases. Spontaneous abortion after surgical treatment occurred in one patient after, emergency operation due to tumor torsion. CONCLUSIONS: Most of the ovarian tumors in pregnancy were benign. Incidence of ovarian malignancies in pregnancy did not exceed 4%. More then 50% of tumors that had not been removed directly after detection disappeared in the course of observation. Spontaneous abortion after operation rarely complicated surgical treatment.     

Ovarian carcinoma during pregnancy: A study of 23 cases in Israel between the years 1960 and 1984

Data from a study on malignant ovarian tumors in pregnancy in Israel are presented. During the 25-year period of the survey, 23 new cases of malignant ovarian tumors during pregnancy were diagnosed, representing an incidence of 0.12/100,000 females over the age of 14; over half of the patients were in their third decade of life at the time of diagnosis of the tumor. Ovarian malignant tumors during pregnancy are more prevalent in Jewish women of European-American origin than in those of Asian-African descent. Borderline carcinomas were found in 35% of our patients; epithelial invasive tumors were found in 30%; the other tumors were dysgerminoma (17%), granulosa cell tumor (13%), and undifferentiated carcinoma (5%). Most of the patients (74%) were diagnosed in stage I. In three cases, ovarian cancer was diagnosed during surgery for tubal pregnancy, and in two during cesarean section at term. In early-stage disease and low-potential-malignancy tumors, surgery can be conservative; thus, 14 of 23 bore a live child. In advanced disease, aggressive surgery, chemotherapy, and/or radiotherapy should be instituted. Factors affecting prognosis were age of patient, histologic type of tumor, and clinical stage of disease. Overall, the survival is much better than that for ovarian tumors in general, because most of the tumors are of low potential malignancy and are diagnosed at an early stage.     

Ovarian thecoma associated in the first trimester of pregnancy

Ovarian thecoma is a relatively rare tumor which occurs before and after menopause. It is extremely rare that pregnancy is complicated with thecoma. Diagnosis of ovarian tumors during pregnancy is highly problematic due to difficulties in obtaining clinical manifestations, and treatment of these tumors poses an even greater challenge. Our patient was found to have estrogen-producing thecoma accompanied by accumulation of ascites in an early phase of pregnancy. The patient underwent abdominal surgery to remove the tumor on the 13th week of gestation. This resulted in disappearance of the ascites and a favorable clinical course. Diagnosis and treatment of ovarian thecoma occurring during pregnancy are discussed with relevant references.     

Ovarian cancer during pregnancy

Objective

To evaluate the clinical features, pregnancy outcome, and treatment of patients with ovarian cancer diagnosed during pregnancy.

Methods

The present study was a retrospective review of 11 cases of ovarian cancer detected during pregnancy. The women were treated and followed up at Selçuk University, Meram Faculty of Medicine, Konya, Turkey, during 2006–2010.

Results

Approximately half the patients were asymptomatic (5 [45.5%]) and diagnosed during cesarean delivery (6 [54.5%]). The histopathologic tumor categories comprised malignant epithelial ovarian tumor (4 [36.4%]), borderline tumor (4 [36.4%]), malignant germ cell tumor (2 [18.2%]), and sex cord stromal tumor (1 [9.1%]). Nine (81.8%) tumors were classified as stage I. Conservative surgery was performed in 10 (90.9%) patients. A patient with stage IIIC serous papillary adenocarcinoma underwent hysterectomy with bilateral salpingo-oophorectomy. A patient with dysgerminoma in stage IV died on follow-up. Three infants were born premature; they were followed up in the neonatal intensive care unit with satisfactory outcomes.

Conclusion

Early diagnosis and appropriate treatment are crucial for patients with ovarian cancer diagnosed during pregnancy. Tumor staging is possible during pregnancy, but the appropriateness of surgery needs to be considered carefully. Ideally, the treatment strategy should be discussed and structured on an individual basis.