卵巢生长性畸胎瘤综合征并文献复习

发布时间：2018-06-17 23:04

本文选题：卵巢肿瘤 + 生长性畸胎瘤综合征　；参考：《临床与实验病理学杂志》2017年07期

【摘要】：目的探讨卵巢生长性畸胎瘤综合征(growing teratoma syndrome,GTS)的临床病理特征、治疗及预后。方法回顾性分析1例卵巢GTS的临床和病理资料,总结其特殊的病程特点和病理学变化。结果超声检查见右侧卵巢包块大小93 mm×72mm,肿瘤大体呈囊实性,实性区以菜花样组织为主,质软,囊内见少量毛发及油脂;镜下肿瘤实性区见多灶未成熟原始神经管;免疫表型:NSE呈阳性,Syn、S-100、CD99、CD56呈局灶阳性;术前肿瘤标志物AFP 48.7 ng/mL、CA125 84.2 U/mL,手术切除右侧卵巢包块、子宫、双侧附件、大网膜及阑尾,术后化疗2次。患者术后17个月复发盆腔包块,彩超示大小47 mm×35 mm×24mm,肿瘤肉眼观察呈实性,质软,部分为骨性组织,镜下可见少量不成熟软骨及间叶组织,肿瘤标志物在正常范围,行盆腔内包块切除,左、右盆腔行淋巴结清扫。术后1个月复查CA125轻度升高,给予连续5次化疗。随访19个月,患者无复发。结论GTS的诊断需结合全部病程,术后复发肿瘤病理诊断为成熟性畸胎瘤是鉴别GTS的重要提示,故应定期检测肿瘤标志物和行腹盆腔超声检查,依据患者个体情况进行合理治疗,避免不必要的化疗。保留年轻患者生育能力和防治术后并发症,是保证良好预后的关键。
[Abstract]:Objective to investigate the clinicopathological features, treatment and prognosis of ovarian growth teratoma syndrome (teratoma syndromes). Methods the clinical and pathological data of one case of ovarian GTS were analyzed retrospectively. Results the size of the right ovarian mass was 93 mm 脳 72 mm, the tumor was cystic and solid, the solid area was mainly vegetable pattern tissue, soft, a small amount of hair and grease were found in the capsule, and many immature primitive nerve tubes were found in the solid area of the tumor under the microscope. The tumor marker AFP 48.7 ng / mL CA125 84.2 U / mL was resected from the right ovarian mass, uterus, bilateral adnexa, omentum and appendix twice after operation. 17 months after operation, the recurrence of pelvic mass was detected by color Doppler ultrasound. The size of the tumor was 47 mm 脳 35 mm 脳 24 mm. The tumor was solid, soft and partial bone tissue. A small amount of immature cartilage and mesenchymal tissue were observed under microscope. The tumor markers were in the normal range. Pelvic mass resection, left and right pelvic lymph node dissection. One month after operation, CA125 was slightly elevated and chemotherapy was given continuously for 5 times. Follow-up for 19 months showed no recurrence. Conclusion the diagnosis of GTS should be combined with the whole course of disease. The pathological diagnosis of recurrent tumors as mature teratoma is an important indication for differentiating GTS. Therefore, the tumor markers and abdominal and pelvic ultrasound should be detected regularly and treated reasonably according to the individual condition of the patients. Avoid unnecessary chemotherapy. Retention of fertility and prevention and treatment of postoperative complications are the key to a good prognosis.
【作者单位】：第三军医大学新桥医院病理科;
【分类号】：R737.31

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