14例卵巢甲状腺肿临床和病理学特征  

Clinical and Pathological Features of Strume Ovarii in 14 Patients

作　　者：高玉平[1] 朱建善[1] 许雁萍[1] 姚维[1] 邱维[1] 林鸿翔[1] 

机构地区：[1]上海第二医科大学仁济医院病理科,上海200001

出　　处：《上海第二医科大学学报》2005年第4期407-409,414,共4页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的探讨卵巢甲状腺肿(SO)的临床和病理学特征。方法回顾性分析14例最后诊断为SO患者的临床资料,总结其临床表现特点和病理学特征。结果14例SO常见症状为腹部包块和腹部不适,3例合并腹水,6例合并同侧或对侧其它卵巢肿瘤。肿瘤均为包膜完整结节,单房12例,多房2例。囊内多为黄褐色胶样物和淡黄绿色液体。镜下见甲状腺滤泡样结构,1例恶性变。免疫组化显示肿瘤细胞甲状腺球蛋白抗体阳性。除1例失访外,其余13例均存活,无复发。结论SO是高度分化单胚层畸胎瘤,罕见。可出现甲状腺的各种组织学形态,恶性变的诊断标准同甲状腺癌。免疫组化甲状腺球蛋白阳性有助于诊断。恶性者可借鉴甲状腺癌的治疗方案,预后良好。Objective To study the clinical and pathological features of struma ovarii. Methods Fourteen patients with struma ovarii were collected and their clinical and pathological features were reviewed. Results Most of the 14 patients with struma ovarii had complaints of lower abdominal palpable masses and discomfort. Ascitic fluid was observed in three cases. In the same side or contralataral side, 6 cases were associated with other ovarian tumors, all 14 tumors had an intact smooth capsular surface. Twelve were multilocular, and two unilo- cular. They were typically filled with gelationous tissue and light green-yellow fluid. Microscopically, the tumors consisted of thyroid follicular structures. The epithelial cells had malignant transformation in one case. Immunohistochemical stains for thyroglobulin were positive. Thirteen patients had remained free of symptoms without relapse and one patient was lost in follow-up. Conclusion Struma ovarii is a highly specialized form of monodermal ovarian teratoma, which is very rare. It may demonstrate all pathological features seen in the thyroid gland, and should be diagnosed by the same histological guidelines for thyroid carcinoma. Immunohistochemical staining for thyroglobulin may be useful to confirm the diagnosis. Malignant struma ovarii is commonly managed based on the experience with carcinoma of the thyroid. The prognosis is generally favorable.

关 键 词：卵巢甲状腺肿 畸胎瘤 甲状腺球蛋白 病理学特征 

分 类 号：R737.31[医药卫生—肿瘤]