卵巢成熟性囊性畸胎瘤合并黏液性交界性肿瘤临床病理观察  

Clinicopathologic features of ovarian mature cystic teratoma combined with mucinous borderline tumor

作　　者：刘磊玉[1] 周赤[1] 荪波[1] 

机构地区：[1]湖北省中医院病理科,武汉430061

出　　处：《诊断病理学杂志》2013年第7期419-421,424,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨卵巢成熟性囊性畸胎瘤合并黏液性交界性肿瘤的临床病理特点、诊断、鉴别诊断及肿瘤发生来源。方法复习1例卵巢成熟性囊性畸胎瘤合并黏液性交界性肿瘤伴上皮内癌患者的临床资料,行组织学观察和免疫组化分析,并复习相关文献。结果患者女性,20岁。CT示左侧卵巢巨大、多房、囊实性包块,界限清楚。巨检:肿瘤18.5 cm×17 cm×7 cm大小,表面光滑,局部破溃,破口处有黏稠的黏液样物流出,切面多房囊实性,囊性部分含黏液样物质,其中一个房内充满皮脂毛发样物;实性部分灰白色,黏滑感。镜检:肠型黏液性上皮细胞呈复层,瘤细胞核大,核分裂象易见,局部腺体共壁或呈筛孔状,间质内未见浸润;其中1个囊腔内衬鳞状上皮,可见毛囊、皮脂腺、汗腺等成分,并可见胃肠型上皮。免疫组化:黏液性上皮CK 7和CK20(+)。结论卵巢成熟性囊性畸胎瘤合并黏液性交界性肿瘤少见,发生上皮内癌变者更为罕见。黏液性交界性肿瘤可能起源于成熟性囊性畸胎瘤的胃肠型上皮成分。Objective To investigate the clinicopathologic features,diagnosis,differential diagnosis of the ovarian mucinous borderline tumor combined with mature cystic teratoma.Methods Review of clinical data,histological observation and immunohistochemical analysis were conducted in 1 case of ovarian mucinous borderline tumor combined with mature cystic teratoma with intraepithelial carcinoma with review of the related literature.Results CT showed a huge multiseptated solid-cystic mass with clear boundaries in the left ovary of a 20-year-old female.Grossly,the tumor measured 18.5 cm× 17 cm× 7 cm in size.It had a smooth surface with a rupture from which thick mucoid matter outflew.The cut surface disclosed multilocular cysts containing myxoid material,one of which composed of hair tufts and mixed yellow sebaceous substance.The solid portion was gray and slippery.Light microscopy showed intestinal-type mucinous epithelial cells were stratified which had enlarged cell nuclei and nuclear fission was obvious.Some glands shared a common wall or even like cribriform.No infiltration was observed in the interstitum.A cystic cavity was lined by squamous epithelium,sebaceous and sweat glands and gastrointestinal epithelial elements.Immunohistochemistry showed mucinous epithelia had diffuse expression for CK7 and focally for CK20＋.Conclusion Ovarian mucinous borderline tumor combined with mature cystic teratoma is unusual.Occurrence of intraepithelial carcinoma is more unusual.Mucinous borderline tumor may originate from gastrointestinal epithelial components of mature cystic teratoma.There is the necessity of a careful exploration of the abdominal and pelvic organ.Extensive sampling is the key to assess such tumors.

关 键 词：卵巢 畸胎瘤 黏液性交界性肿瘤 

分 类 号：R737.31[医药卫生—肿瘤]