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。

Clinicopathologic study of struma ovarii with emphasis on diagnosis and differential diagnosis

Objective：To investigate the clinical and pathological features of struma ovarii. Methods：Twenty one cases of struma ovarii were studied by light microscopy, immuno- histochemistry and analysis of clinical features. The relative literatures were reviewed. Results： The average age of the patients was 45.1 years old （range from 25 to 67 ）. The patients mainly presented as pelvic mass or ovarian cystic mass. The morphological characteristic was similar to those of orthotopic thyroid. Among these 21 cases, there were 4 cases of pure struma, 16 cases of mixed struma and one malignant struma （ partially showed thyroid type papillary carcinoma）.The postoperative course was uneventful. According to the literature, metastases rarely occurred to thyroid-type papillary carcinomas, and most of patients with recurrence and/or metastases were those of follicular type and mixed papillary-follicular type. Conclusion：Stmma ovarii are rare ovarian monodermal teratoma, with low rate of malignant change and good prognosis. Some cases of struma ovarii should be differentiated from ovarian carcinoid, clear cell carcinoma,granuloasa cell tumor and so on.