卵巢幼年型颗粒细胞瘤四例临床分析

目的 探讨卵巢幼年型颗粒细胞瘤的诊断,治疗和预后。方法 回顾性分析自1983年至2002年间北京协和医院收治的4例卵巢幼年型颗粒细胞瘤的临床资料。结果 卵巢幼年型颗粒细胞瘤的发生率极低,主要发生在青少年及儿童,临床表现为盆腔实性包块伴胸腹水,4例患者雌二醇水平均在正常范围,手术病理分期为Ⅰ期。确诊主要依据病理检查,所有患者接受手术 化学药物治疗（化疗）。其中,2例呈高核分裂相的患者病情很快恶化,分别于发病后10和14个月死亡;2例低分裂相的患者现无瘤生存分别为32和25个月。结论 卵巢幼年型颗粒细胞瘤的诊断主要依据病理检查,核分裂相高者预后不良,治疗以手术为主,辅以化疗可能改善预后。

Clinical analysis of 4 cases of juvenile granulosa cell tumor of the ovary

OBJECTIVE: To review the diagnosis, treatment and prognosis of juvenile granulosa cell tumor of the ovary (JGCT). METHODS: To review four patients with JGCT treated in Peking Union Medical College Hospital from 1983 to 2002. RESULTS: JGCT is rare and most of the patients are adolescent or children. Solid pelvic mass with ascites and pleural effusion were mainly clinical feature. The levels of estrogen of the four patients were normal. Diagnoses were made by pathology. All 4 patients were at stage I and treated with surgery and combined chemotherapy. Two patients with high mitotic index progressed and died after 10 and 14 months, and the others without high mitotic index obtained a complete remission for 25 and 32 months. CONCLUSIONS: The diagnosis of JGCT is made by pathology definitely. The prognosis is poor when patient has high mitotic index. Cytoreductive surgery is the treatment of choice and combination chemotherapy may be helpful to improve the prognosis of JGCT.