卵巢囊性成熟性畸胎瘤恶变11例分析

为了了解卵巢囊性成熟性畸胎瘤恶变临床特征及预后,对11例卵巢囊性成熟性畸胎瘤恶变的临床症状、肿瘤分期、病理类型、治疗进行回顾性分析。结果11例患者平均生存时间为68．6个月（12－168个月）,5年生存率为57．2％。研究结果提示,卵巢囊性成熟性畸胎瘤恶变发生率低、恶性度高,手术治疗,辅以化、放疗有一定疗效。     

卵巢成熟性畸胎瘤恶变临床病理分析

目的:探讨卵巢成熟性囊性畸胎瘸恶变的临床病理特点.方法:收集8例卵巢成熟性囊性畸胎瘤恶变肿瘤,分析病变的临床表现、病理特征分期及随访结果.结果:卵巢成熟性囊性畸胎瘤恶变多发生于绝经后女性.8例中2例为类癌,2例为恶性甲状腺,1例黏液腺癌,1例上皮内癌,1例甲状腺肿类癌,1例鳞状细胞癌.8例均为临床Ⅰ期,除1例死亡外,其余7例均无瘤生存.结论:卵巢成熟性囊性畸胎瘤恶变率低,病理检查需细致全面,结合临床综合治疗1期患者预后良好.     

卵巢成熟性畸胎瘤恶变为腺癌1例

卵巢成熟性畸胎瘤恶变为腺癌十分罕见,确诊主要依赖病理检查及免疫组化,治疗以手术治疗为主,辅以化疗或放疗,临床Ⅰ期预后相对较好.本文回顾性分析1例卵巢成熟性畸胎瘤恶变为腺癌病例的临床特点及诊治方法,并结合相关文献进行总结报道,以提高对这类疾病的认识.     

卵巢畸胎瘤恶变的病理及临床分析

卵巢成熟型畸胎瘤恶变不多见，我院１９６１－１９９１年收治成熟型囊性畸胎瘤恶变２２例，占同期卵巢恶性肿瘤的５．１４％，其中鳞癌１８例，腺癌与肉瘤各２例。治疗方法以手术为主，绝大多数辅以化疗。患者的预后与肿瘤的组织类型、临床分期及治疗方法有关，鳞状上皮性恶变预后较佳；临床期别愈早疗效愈好；治疗手段以细胞减炒术并辅以化疗效果较好。     

卵巢成熟性囊性畸胎瘤恶变临床及预后分析

卵巢成熟性囊性畸胎瘤恶变临床并不多见 ,一般认为其发生率低于卵巢成熟性囊性畸胎瘤恶变及卵巢未成熟性畸胎瘤 ,多发生于老年妇女。现对我科1986年— 1999年间收治的 13例卵巢成熟性囊性畸胎瘤恶变病例的临床及预后因素分析如下。1　资料与方法1.1　一般资料　 13例卵巢成熟性囊性畸胎瘤恶变占本院同期收治卵巢恶性肿瘤的 1.32 % ,卵巢成熟性囊性畸胎瘤发病年龄偏小 ,而恶变时年龄较大。本组13例中 84.6 %发生在 41岁～ 6 9岁 ,中位年龄 48岁 ,已绝经者占 6 1.5 %。1.2　临床表现　 13例卵巢成熟性囊性畸胎瘤恶变中 11例有下腹胀或下腹部肿…     

卵巢成熟型囊性畸胎瘤合并类癌及黏液性囊腺癌1 例报告

患者女性,72岁,主诉下腹坠胀不适3个月余,近期出现尿急、尿频等不适,平素月经规律,于25年前自然绝经。2013年10月于兰州军区总医院妇科就诊。妇科检查:盆腔可扪及一大小约20 cm×20 cm肿物,质硬,活动度尚可。实验室检查:CEA为6.7μg/L。B超检查:盆腔内显示以囊性为主的混合型14.7 cm×11.9 cm肿物,壁厚,内见光带分隔及不规则较强回声。行子宫全切术、双侧附件全切术、大网膜切除术。病理检     

卵巢成熟性畸胎瘤恶变的术中冷冻切片分析

背景与目的：卵巢成熟性畸胎瘤(mature cystic teratoma,MCT)发生恶变非常罕见,术前诊断困难,常需通过术中快速冷冻切片(frozen section,FS),明确诊断后指导临床医师开展进一步手术,该研究旨在探讨卵巢MCT发生恶变时,导致术中冷冻切片诊断与最终诊断不一致的相关因素,以期提高其诊断的准确性。方法：回顾性分析2008年9月—2017年9月就诊于四川大学华西第二医院的MCT病例,重点分析发生恶变病例的临床病理学特征及导致术中冷冻发生误诊的因素,并复习相关文献。结果：9 213例卵巢MCT患者中有5 790例送检术中冷冻切片,发生恶变的患者共18例。恶变成分为鳞状细胞癌8例、腺癌6例、类癌1例、腺鳞癌1例、恶性纤维组织细胞瘤1例及恶性黑色素瘤1例。18例患者中有14例术中冷冻切片诊断与最终诊断的肿瘤良恶性相符合,4例通过冷冻切片能够确定恶性成分发生于卵巢畸胎瘤。结论：对卵巢畸胎瘤恶变冷冻切片诊断与最终诊断不符合的病例复检切片发现,取材失误是主要原因。尽管术前诊断困难,在基本危险因素（患者年龄和肿瘤体积）之外结合影像学改变并伴有血清肿瘤标志物升高时应该积极开展术中冷冻切片检查以明确诊断。     

卵巢成熟性囊性畸胎瘤伴黏液性囊腺癌1例

患者,女性,53岁,因下腹部包块4个月,伴阴道不规则流血、腹痛入院.妇科检查:外阴正常,阴道通畅,宫颈光滑,子宫后位,正常大小,宫体右上方触及1个约13 cm×12 cm包块,质硬,表面光滑,活动度尚可.彩超示:子宫右侧囊性肿物,不排除畸胎瘤.     

卵巢成熟囊性畸胎瘤恶变临床病理观察

目的探讨卵巢成熟囊性畸胎瘤(Mature cystic teratoma,MCT)恶变的临床病理特征.方法回顾性分析卵巢MCT恶变10例,对其病理分型、临床特点进行讨论.结果卵巢MCT恶变占良性MCT的1.7%,其中鳞状细胞癌8例,基底细胞癌1例,腺癌1例.临床多表现为下腹部肿物,8例局限于卵巢,2例侵犯宫旁、盆壁及直肠.2例死亡,其余8例均无瘤生存.结论卵巢MCT恶变多发生于绝经后妇女,以鳞癌为最多;当卵巢MCT囊壁较厚时,病理检查需细致,警惕其恶变.治疗以手术为主;肿瘤局限于卵巢者预后较好,已侵犯其它部位者预后差.     

56例卵巢成熟性畸胎瘤的诊治分析

５６例卵巢成熟性畸胎瘤的诊治分析邓运莲衡阳医学院附属第二医院妇产科（衡阳市４２１００１）成熟性畸胎瘤是卵巢常见的良性肿瘤之一，它来源于生殖细胞，约占生殖细胞肿瘤的９４．７％。我院１９８９年１月至１９９３年６月共诊治卵巢肿瘤１７６例，其中卵巢成熟性畸胎...     

Characteristics and Treatment Outcomes of Patients with Malignant Transformation Arising from Mature Cystic Teratoma of the Ovary: Experience at a Single Institution

Background: Malignant transformation arising in mature cystic teratoma (MCT) is one of the most seriouscomplications of MCT. Squamous cell carcinoma is the most common malignant change. Some clinical findingssuch as advanced age group and large tumor size are significant risk factors of malignant transformation.This study was conducted in order to evaluate characteristics, cell types, treatment and outcome of malignanttransformation arising from dermoid cysts in our institution. Materials and Methods: A retrospective chart reviewwas performed. General characteristics, operative data, procedure, operative finding and operative outcomewere analyzed. Statistical assessment was performed with SPSS version 17.0, using mean, mode, median andpercentage to describe those data. Results: During the 10 years period, 11 cases of malignant transformation froma total of 753 cases (1.46% incidence) of MCT were reviewed. Mean age of the patients was 41.2 years (SD 4.34,range 24-70). The most common presenting symptom was a palpable mass (8 cases; 72.7%). Primary surgicalstaging was performed in 4 patients (36.4%). Re-staging was conducted in the other 4. Complete cytoreductionwas obtained in 45.5% (5 cases) and optimal surgical resection was obtained in 36.4% (4 cases). Mean tumorsize was 14.1 cm. (SD 1.55, range 6-20). Squamous cell carcinoma was found in 36.4% (4 cases) and mucinouscancer in the other 4. More than half of them were stage Ia (54.5%, 6 cases). All patients whose stage morethan Ia received chemotherapy (45.5%). Mean disease free survival was 5.53 years (1.32, 0.3-10). Conclusion:According to our study, the incidence of malignant transformation was consistent with previous studies. Thecommon malignant transformation histologic types are both squamous and mucinous carcinoma which differedfrom previous reports. Early detection for early stage disease and optimal surgery are important for long termsurvival.     

Hypercalcemia Associated with a Malignant Brenner Tumor Arising from a Mature Cystic Teratoma

A 60-year-old woman presented with abdominal pain and weight loss and was found to have serum calcium of 15.0 mg/dl. Serum parathyroid hormone-related peptide (PTHrP) returned elevated. Imaging suggested bilateral mature cystic teratomas. Her hypercalcemia was treated initially with intravenous saline, as well as intramuscular and subcutaneous calcitonin. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, and final pathology revealed malignant Brenner tumor in association with a mature cystic teratoma. Her postoperative PTHrP returned less than assay, and her total and ionized calcium fell below normal, requiring supplemental calcium and vitamin D. At follow-up one month after discharge, her calcium had normalized. We present the first reported case of hypercalcemia occurring in association with a malignant Brenner tumor. Malignancy-associated hypercalcemia occurs via four principal mechanisms: (1) tumor production of PTHrP; (2) osteolytic bone involvement by primary tumor or metastasis; (3) ectopic activation of vitamin D to 1,25-(OH)₂ vitamin D, and (4) ectopic production of parathyroid hormone. PTHrP-mediated hypercalcemia is the most common mechanism and was responsible in this case. In patients with paraneoplastic hypercalcemia who undergo surgical treatment, close monitoring and management of serum calcium is necessary both pre- and postoperatively.Key Words: Hypercalcemia, Parathyroid hormone-related peptide, Mature cystic teratoma, Malignant Brenner tumor     

卵巢成熟畸胎瘤516例临床分析

卵巢成熟畸胎瘤是育龄期妇女常见疾病。全文回顾性分析516例卵巢成熟畸胎瘤患者资料,429例术前经B超诊断;肿瘤以单侧为多见（443例）。281例行开腹手术,235例行腹腔镜手术,腹腔镜手术在缩短平均住院日、减少术中出血量、缩短手术时间上均较开腹手术优。并发症以畸胎瘤扭转最常见,达8.1%。术后6年复发率为5.4%（11/204）。     

Neuroendocrine Tumor Arising within Mature Cystic Teratoma of the Pancreas: Literature Review and Case Report

Cystic teratomas are germ cell tumors most commonly found in the ovaries and testes. The pancreas, however, is very rare as a site of occurrence. Moreover, only two cases of cystic teratoma with concomitant neuroendocrine tumor have been reported to date. We report the case of a 33-year-old female who presented with abdominal pain. Computed tomography and magnetic resonance imaging of the upper abdomen revealed an 85 mm cystic tumor in the head of the pancreas. Cystic teratoma and mucinous cystadenoma were suggested as differential diagnoses. Cytopathologic analysis of endoscopic ultrasound-guided fine needle aspiration was consistent with mucinous cystadenoma. Therefore, the patient underwent surgical resection. Histologic analysis revealed a mature cystic teratoma of the pancreas with a concomitant neuroendocrine tumor. The patient is in great condition at 8 months follow-up. Cystic teratoma of the pancreas with a concomitant neuroendocrine tumor is an extremely rare condition. Surgical resection remains the mainstay of treatment as it provides a definitive diagnosis and no recurrences have been reported to date.     

胰腺囊性肿瘤11例诊治分析

[目的]分析胰腺囊性肿瘤的临床病理特征。[方法]收集并分析1992年2月至2007年10月共诊治11例胰腺囊性肿瘤的临床资料,病例均经病理学证实。[结果]术前误诊4例06．4％1。病变位于胰头部4例,胰体尾部7例。肿瘤直径5．0～20．5cm,平均7．5cm。从发病到就诊时间最短1个月。最长4余年。胰十二指肠切除3例,胰体尾及脾切除4例,单纯性囊性肿瘤切除术2例．单纯剖腹探查、肿瘤活检1例。无手术死亡病例。[结论]胰腺囊性肿瘤易误诊．临床上应予仔细鉴别诊断。治疗首选手术切除。     

Malignant Transformation Rate and P53, and P16 Expression in Teratomatous Skin of Ovarian Mature Cystic Teratoma

Objective: To investigate the incidence of malignant transformation and P53 and P16 expression interatomatous skin of ovarian mature cystic teratoma. Materials and Methods: Data on ovarian teratomaspecimens in nearly 10 years were reviewed. P53 and P16 expression were detected by immunohistochemistryin 25 cases of teratomatous skin of ovarian mature cystic teratoma, 20 cases of squamous cell carcinoma and 2cases of squamous cell carcinoma originated from teratomatous skin. Results: Of 1913 cases of ovarian maturecystic teratoma in nearly 10 years, only two cases of squamous cell carcinoma were found in teratomatous skin,with malignant transformation rate of 0.1045%. P53 expression was detected in 2 cases squamous cell carcinomaoriginated from teratomatous skin and P16 overexpression in one. There were no expressions of P53 and P16 in25 cases of teratomatous skin of ovarian mature cystic teratoma. Of 20 cases of squamous cell carcinoma P53overexpression (positive rate of 55%) was detected in 11 cases, P16 overexpression (positive rate of 35%) in 7cases. The positive rates of P53 and P16 expression in squamous cell carcinomas were significantly higher thanthat in the teratomatous skins (p< 0.001, p= 0.002). Conclusions: There was low risk of malignant transformationin teratomatous skin of ovarian mature cystic teratoma which can be explained by lower P53 and P16 expressioninteratomas than that in squamous cell carcinoma.     

Trichoadenoma in a mature Cystic Teratoma: A Rare Finding

Skin adnexal tumors arising in dermoid cysts of the ovary are exceedingly rare. We report a trichoadenoma arising in a dermoid cyst in a 42-year-old female. The histopathology of trichoadenoma has also been described briefly. Mature teratomas, which are almost all cystic (dermoid cysts), account for approximately 25% of all ovarian tumors, and 30% of benign ovarian tumors. They usually develop in children or women of the reproductive age group. Histologically, they are composed of variable proportions of tissue originating from the ectoderm, mesoderm, and endoderm. Cystic cavities are lined by mature epidermis. Although skin appendages and neural tissue are extremely common, there are only few case reports of skin adnexal tumors arising in a mature teratoma. We report a case of ovarian teratoma with a trichoadenoma. To the best of the authors' knowledge, this is the first report describing this rare benign skin adnexal tumor, in a mature cystic teratoma of the ovary. Keywords: trichoadenoma, mature cystic teratoma.     

Primitive Neuroectodermal Tumor in an Ovarian Cystic Teratoma: Natural Killer and Neuroblastoma Cell Analysis

In the present study, we report an extremely rare case of a 31-year-old woman with neuroblastoma arising in an ovarian cystic teratoma. We analyzed the expression of activating receptors on natural killer (NK) cells derived from the patient''s peripheral blood and peritoneal fluid. In addition, we investigated the presence of specific ligands recognized by different NK cell receptors on tumor cells. We show that NK cells isolated from peritoneal fluid expressed certain triggering receptors including DNAM-1 (CD226) and CD16 with lower intensity as compared to peripheral blood NK cells. Remarkably, at variance with most cases of childhood neuroblastoma, the tumor cells from this patient expressed substantial amounts of HLA class-I molecules. These molecules are known to be protective against NK cell-mediated lysis. In addition, neuroblastoma cells expressed B7-H3 (CD276), another surface molecule that inhibits NK cell function. Finally, this tumor did not express the PVR (CD155) and nectin-2 (CD112) ligands for the DNAM-1 activating NK receptor, which plays a crucial role in NK/neuroblastoma interactions. Altogether, these findings indicate that the neuroblastoma cells of this patient express an NK-resistant surface phenotype, which is at least in part similar to that previously described in a fraction of childhood neuroblastoma.Key words: Activating natural killer receptors, Natural killer cells, Neuroblastoma, Ovarian cancer     

复发性卵巢未成熟畸胎瘤21例分析

目的探讨复发性卵巢未成熟畸胎瘤的特点、治疗、预后及影响因素。方法对1981年3月～2007年7月中山大学附属肿瘤防治中心共收治的23例复发性卵巢未成熟畸胎瘤影响预后的因素进行回顾性分析。结果复发性未成熟畸胎瘤的3年生存率为90.2%,5年生存率为79.9%;病灶单发和多发者的5年生存率分别为78.2%和72.1%,P=0.051;局限于盆腔和超出盆腔者的5年生存率分别为100.0%和73.3%,P<0.05;首次复发术后无残留灶和有残留灶且(2cm者的5年生存率分别为75.0%和64.8%,P<0.05;首次复发术后病理分级0级和Ⅰ～Ⅲ级者的5年生存率分别为80.8%和64.6%,P<0.05;首次复发术后化疗始于2周内和大于2周的5年生存率分别为81.3%和70.2%,P<0.05。结论影响患者预后的因素可能有:复发部位、首次复发术后残留灶、首次复发术后病理分级、首次复发术后开始化疗时间;患者经综合治疗仍可获较好疗效。