卵巢恶性生殖细胞肿瘤的化疗及进展

卵巢恶性生殖细胞肿瘤是来源于卵巢生殖细胞的恶性肿瘤，约占所有卵巢恶性肿瘤的5％～20％，主要包括卵黄囊瘤、未成熟畸胎瘤、无性细胞瘤、胚胎癌、原发绒癌及混合性生殖细胞肿瘤。其多数对化疗极其敏感，化疗已经成为其非常重要的治疗手段。     

来源于卵巢成熟性囊性畸胎瘤的恶性黑色素瘤1例及文献复习

<正>来源于卵巢成熟性囊性畸胎瘤(mature ovariancystic teratoma,MOCT)的恶性黑色素瘤(malignantmelanoma,MM)极为罕见,是MOCT恶变中最少见的恶性肿瘤类型[1]。     

卵巢甲状腺肿临床病理学分析

目的：探讨卵巢甲状腺肿的临床及病理组织学特征。方法：观察总结21例卵巢甲状腺肿的临床及病理学特征，并对手术切除标本进行免疫组织化学染色，同时复习相关文献。结果：卵巢甲状腺肿平均发病年龄为45．1岁（25-67岁），以盆腔肿物或卵巢囊性肿物为主要临床表现，组织学表现类似于颈部甲状腺组织本身的病变。其中单纯性甲状腺肿4例，混合性甲状腺肿16例，恶性甲状腺肿1例（部分恶变为甲状腺型乳头状癌）。术后无复发转移。文献显示，乳头状癌极少出现转移，绝大多数复发转移是滤泡性癌或滤泡-乳头混合性癌。结论：卵巢甲状腺肿是少见的卵巢单胚层畸胎瘤，恶变率低，预后好。部分病例需注意与卵巢类癌、透明细胞癌、粒层细胞瘤等鉴别。     

卵巢恶性生殖细胞肿瘤保留生育功能的治疗策略

正卵巢恶性生殖细胞肿瘤(malignant ovarian germ cell tumors,MOGCTs)来源于胚胎性腺的原始生殖细胞,在亚洲及我国约占卵巢恶性肿瘤的12%~25%,多发于青少年女性和儿童。MOGCTs包括无性细胞瘤、未成熟畸胎瘤、卵黄囊瘤(又称内胚窦瘤)、胚胎癌、原发性绒癌以及混合性生殖细胞肿瘤等多种组织病理     

卵巢甲状腺肿类癌

卵巢甲状腺肿类癌是一种罕见肿瘤,属单胚层高度特殊性畸胎瘤。通过对近年来一些病例总结发现其为一低度恶性肿瘤,多以盆腔肿块为首发表现,可伴有便秘,内分泌紊乱等症状,少数伴有类癌综合征。组织病理由类癌与甲状腺滤泡组成,以梁型类癌伴甲状腺滤泡多见,免疫组化分析存在甲状腺球蛋白及嗜银、亲银颗粒。治疗多行单侧附件切除或全子宫加双附件切除,多数预后良好。     

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。     

卵巢畸胎瘤598例临床病理分析

目的探讨卵巢畸胎瘤的临床特点及处理方法。方法收集我院妇产科1990年1月～2003年9月间收治卵巢畸胎瘤598例，建立数据库后对其临床特点及处理原则进行分析。结果卵巢畸胎瘤中成熟性囊性畸胎瘤占93．6％，合并其他卵巢良性肿瘤21例，合并其他卵巢恶性肿瘤4例。61．9％患者是在妇检及，或超声检查时发现，儿童及未婚妇女往往在出现并发症时才发现，超声检查符合率达90．8％，妊娠合并畸胎瘤直径≤6cm发生蒂扭转等并发症。结论①要加强对儿童及未婚妇女的妇科检查；②成熟性囊性畸胎瘤可合并其他卵巢良性和恶性肿瘤，术中快速冰冻切片是决定手术方式的重要依据；③妊娠合并卵巢畸胎瘤若直径≤6cm，可考虑保守期待。     

卵巢恶性生值细胞肿瘤的化疗

卵巢恶性生值细胞肿瘤的化疗６１００４１华西医大附二院王世阆恶性生殖细胞肿瘤主要包括未成熟畸胎瘤、内胚窦庙、无性细胞瘤、胚胎场、原发性绒癌及混合性生殖细胞瘤等。这组来源于生殖细胞的恶性肿瘤，大多为高度恶性肿瘤，由于化疗的应用，预后得到明显改善。一、化疗...     

卵巢成熟性囊性畸胎瘤鳞状细胞癌变诊治进展

<正>卵巢成熟性囊性畸胎瘤(mature cystic teratoma,MCT)是最常见的卵巢生殖细胞肿瘤,占卵巢肿瘤的10%~25%。瘤体可含外、中、内三胚层成分,任何一种成分都可能恶变,恶变率为1.8%[1],其中以鳞状细胞癌(squamous cell carcinoma,SCC)最常见,占恶变总数的75%~85%[2-5]。卵巢成熟性囊性畸胎瘤鳞状细胞癌变(squamous cellcarcinoma arising from mature cystic teratoma,SCC-MCT)在临床上非常罕见,目前对其临床诊     

卵巢无性细胞瘤的治疗

卵巢无性细胞瘤是少见的卵巢胚细胞恶性肿瘤,约占卵巢恶性肿瘤的2％。无性细胞瘤可单独发生,也可作为胚细胞肿瘤如恶性畸胎瘤、绒癌或卵巢内胚窦瘤的成分之一。本病预后各作者的差别很大,与治疗及肿瘤是单发还是混有其他胚细胞成分有关。材料和方法本文报道1947至1974年间某医院治疗的36例病     

Mucinous adenocarcinoma and strumal carcinoid tumor arising in one mature cystic teratoma of the ovary with synchronous cervical cancer

Malignant transformation of mature cystic teratoma is an uncommon complication. While any of the constituent tissues of a teratoma has the potential to undergo malignant transformation, squamous cell carcinoma is the most commonly associated cancer. We present an unusual case of a postmenopausal woman with synchronous mucinous adenocarcinoma and strumal carcinoid tumor from one of two ovarian mature cystic teratomas (one in each ovary) with synchronous cervical cancer. We suggest that malignant transformation of mature cystic teratoma and synchronous cervical cancer be treated by hysterectomy, chemotherapy, and radiotherapy.     

Follicular variant of papillary thyroid carcinoma arising from a dermoid cyst: A rare malignancy in young women and review of the literature

ObjectiveBenign or mature cystic teratomas, also known as dermoid cysts, are composed of mature tissues, which can contain elements of all three germ cell layers. Malignant transformation of a mature cystic teratoma is more common in postmenopausal women, however, it can also, rarely, be identified in younger women. We present a case of a 19-year-old woman with malignant transformation of an ovarian mature cystic teratoma.Case ReportOur case was a 19-year-old woman, who was diagnosed postoperatively with follicular variant of papillary thyroid carcinoma in a mature cystic teratoma. She underwent right cystectomy for adnexal mass. Postoperative metastatic workup revealed a non-metastatic disease and the patient did not undergo any further treatment. After 2 months, a near-total thyroidectomy was performed. Serum thyroglobulin levels were monitored on follow-up and the patient is asymptomatic.ConclusionMalignant transformation of a dermoid cyst is a rare ovarian neoplasm. We believe that unilateral oophorectomy or cystectomy is a reasonable treatment option for cases in which there is no evidence of capsular invasion, vascular invasion or gross metastasis, and preservation of fertility is desired. Total thyroidectomy was diagnosed in selected cases. Serial serum thyroglobulin should be used as a tumor marker for follow-up.     

Primary carcinoid tumor of the ovary: a case report

Primary ovarian carcinoid tumors are rare. A 47-year-old woman presented to our emergency room with lower abdominal pain. Physical examination, pelvic ultrasonographic evaluation and abdominal computed tomography revealed a 10-cm mass in the right ovary containing cystic and solid components, as well as calcifications typical of a dermoid cyst. At laparotomy, a smooth-surfaced, firm and mobile right adnexal mass with solid and cystic portions was detected. Initially, right salpingo-oophorectomy was performed. Frozen-section examination identified the mass as a sex cord stromal tumor containing a mature cystic teratoma. Based on this finding, total abdominal hysterectomy, left salpingo-oophorectomy, omentectomy, appendectomy were performed, and the pelvic-paraaortic lymph nodes were also removed. All histological findings in the right ovary were similar to the features of cystic teratoma and trabecular carcinoid tumor. Examination of the resected lymphatic, omental, and appendiceal tissue indicated no tumoral invasion. The diagnosis was ovarian carcinoid Stage IA. Serum testing post-surgery revealed that the levels of cancer antigen (CA) 19-9 and CA125 were 18.5 u/ml and 10.5 u/ml, respectively. The patient was discharged on postoperative day 5. The report describes the clinicopathologic and immunohistochemical features of a primary ovarian carcinoid that contained a mature cystic teratoma.     

Squamous cell carcinoma arising from mature cystic teratoma of the ovary with synchronous endometrial adenocarcinoma

Squamous cell carcinoma arising from a mature cystic teratoma of the ovary is a rare event representing only 1-2% of all mature cystic teratomas. Furthermore, the synchronous occurrence of a second malignancy in this setting is extremely rare. A 63-year-old woman presented with a pelvic mass which was diagnosed as a left ovarian mature cystic teratoma preoperatively by ultrasonography. The frozen section of the mass revealed a left ovarian mature cystic teratoma with a focus of squamous cell carcinoma. Subsequently surgical staging procedure for ovarian cancer was performed. The final pathologic diagnosis was squamous cell carcinoma in mature cystic teratoma of the ovary, and synchronous endometrial adenocarcinoma with a mixture of endometrioid and mucinous subtypes as an incidental finding. The combination of these two synchronous cancers is unique and to the best of our knowledge, this has not been previously reported in the English language literature.     

Ovarian neoplasm composed of an insular carcinoid tumor and a borderline mucinous cystadenoma arising in a mature cystic teratoma: a case report

We report the case of a 57-year-old female patient with an ovarian neoplasm of insular carcinoid and mucinous cystadenoma of low malignant potential, arising in a cystic teratoma of the right ovary. Additionally, a mature teratoma of the left ovary was present. This is an extremely rare combination of primary tumors in the ovary. The possible common histogenesis of the afore-mentioned tumors is discussed.     

Gamma mode of infiltration associated with poor prognosis in malignant teratoma of the ovary: A case report

BACKGROUND: Although mature cystic teratoma is the most common tumor of the ovary, squamous cell carcinoma arising from a mature teratoma is a rare event. Prognosis depends on clinical stage, grade, and recently described mode of tumor infiltration. CASE: This case involves a 52-year-old woman with stage II squamous cell carcinoma arising in a mature cystic teratoma of the left ovary. Final pathology demonstrated poorly differentiated squamous cell carcinoma with gamma mode of tumor infiltration. The patient completed adjuvant chemotherapy and subsequently died of progressive disease. CONCLUSION: Squamous cell carcinoma arising from a benign cystic teratoma is a rare event. Studies have shown stage, grade, and mode of infiltration to be predictors of recurrence and prognosis. This case supports the growing evidence linking the mode of tumor infiltration with overall prognosis of survival.     

Sebaceous carcinoma arising within an ovarian cystic mature teratoma

A 77-year-old woman presented with an abdominal swelling and underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy for a left ovarian tumor. This was an ovarian mature cystic teratoma in which had developed a sebaceous cell carcinoma. This is a rare form of ovarian malignancy whose behavior is poorly documented. The treatment and follow-up of this case are discussed.     

Adenocarcinoma arising from respiratory ciliated epithelium in benign cystic teratoma of the ovary: a case report with analyzes of the CT, MRI, and pathological findings

The malignant transformation of mature cystic teratoma is rare, thus occurring in only 1-2% of all cases. The most common malignancy arising in mature cystic teratoma is squamous cell carcinoma. Adenocarcinoma occurs with less frequency. We herein present a patient with an ovarian mature cystic teratoma who demonstrated a malignant transformation to well-differentiated adenocarcinoma. Malignant transformation was diagnosed preoperatively by contrast enhanced computed tomography (CT) and magnetic resonance imaging (MRI). Microscopically and immunohistochemically, the adenocarcinoma was considered to have arisen from the ciliated respiratory epithelium. After a 28-month of follow-up period, she remains free of the disease. This is the third reported case of adenocarcinoma arising in the respiratory epithelium of an ovarian mature cystic teratoma. Contrast enhanced CT and MRI are useful for making a preoperative diagnosis and an immunohistochemical study is helpful for defining its origin.     

Adenocarcinoma arising from respiratory ciliated epithelium in mature ovarian cystic teratoma

Malignant transformation of a mature cystic teratoma of the ovary is rare, that of an adenocarcinoma is extremely rare. A 32-year-old woman was suspected as having a malignant transformation of her mature cystic teratoma of the ovary because the preoperative level of carcinoembryonic antigen (CEA) was extremely high. Resections of her ovarian cysts were performed, and this particular tumor was histopathologically diagnosed as an adenocarcinoma arising from a mature cystic teratoma of the left ovary. Because adenocarcinomas arising from mature cystic teratomas of the ovary are extremely rare, we report this case with a review of some of the literature.     

Squamous cell carcinoma arising in a mature cystic teratoma of the ovary with synchronous invasive lobular breast cancer: case report

Malignant transformation of a mature ovarian cystic teratoma is the most serious complication of this relatively common neoplastic lesion. While any constituent tissue of the teratoma can undergo malignant transformation, squamous cell carcinoma represents approximately 80% of those malignancies. Furthermore, the synchronous occurrence of a second malignancy in that setting is extremely rare. Preoperative diagnosis of malignant transformation within a mature cystic teratoma is extremely difficult and poses a great challenge to current clinical surgical practice. The particularly aggressive behavior of this rare tumor, also poses significant surgical managing dilemmas. We present a case report of a premenopausal woman with an invasive squamous cell carcinoma arising in a mature cystic teratoma and a synchronous invasive lobular carcinoma of the breast.