卵巢甲状腺肿类癌临床病理分析  

Clinicopathologic study of strumal carcinoid of ovary and literature review

作　　者：张晓波[1] 徐游贵 沈丹华[1] ZHANG Xiao-bo;XU You-gui;SHEN Dan-hua(Department of Pathology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院病理科,北京100044

出　　处：《中华肿瘤防治杂志》2021年第19期1498-1502,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨卵巢原发甲状腺肿类癌的临床病理学特征、诊断及鉴别诊断。方法收集2009-01-01-2019-12-31北京大学人民医院病理科确诊的18例卵巢原发甲状腺肿类癌患者病理资料。将癌组织进行组织学形态观察,免疫组化染色,分析其临床病理特征。结果患者年龄18~72岁,平均年龄45.2岁,5例表现为下腹部疼痛,13例为体检或其他原因发现腹部包块。11例发生于左侧卵巢,7例发生于右侧卵巢。肿瘤大小为0.2 cm×0.2 cm~7.0 cm×6.0 cm。镜下检查18例卵巢甲状腺肿类癌同时伴有成熟性囊性畸胎瘤成分。其中11例有完整的免疫组化结果。CKpan、CK7和Syn全部呈阳性,TTF1和TG在甲状腺区域全部为阳性,有4例在类癌区域呈阳性,8例CgA阳性,有4例CDX2为阳性,Ki-67增殖指数为1%~5%。18例随访时间5~120个月,中位随访时间75.21个月,均未见复发或转移。结论卵巢原发性甲状腺肿类癌是一种非常罕见的恶性肿瘤,具有低度恶性。诊断主要依靠组织病理学特征及免疫表型。预后良好。Objective To describe the clinicopathologic features, diagnosis and differential diagnosis of ovarian carcinoid tumors.Methods The data diagnosed with primary ovarian carcinoid tumors at Peking University People’s Hospital were collected from January 1,2009 to December 31,2019.The tumor tissues were observed by histological morphology, immunohistochemical staining, and the clinicopathological characteristics were analyzed in combination with relevant literature.Results The age of patients ranged from 18 to 72 years old(the average age was 45.2 years).Five patients presented with pain in the lower abdomen, and thirteen patients were found a pelvic mass due to health check-up.The left ovary was involved initially in eleven patients, and the right one in seven patients.The major axis of the tumor ranged from 0.2 cm×0.2 cm to 7 cm×6 cm.All eighteen cases were complicated with mature cystic teratoma.Completed immunohistochemical results were obtained in eleven cases.All cases showed immunoreactivity for Ckpan, CK7 and Syn, the positive proportion of CgA was 8/11,the positive proportion of CDX2 was 4/11.While all of the thyroid follicles were positive for TTF1 and TG,only four cases were positive in strumal carcinoid.The positive index of Ki67 was 1%-5%.Eighteen patients were followed up for 5-120 months, with an average follow-up time of 75.21 months, without recurrence or metastasis.Conclusions Strumal carcinoid of ovary is a very rare low-grade malignant tumor.The diagnosis mainly relies on the histopathologic characteristics and the immunophenotype with relatively good prognosis.

关 键 词：卵巢 甲状腺肿类癌 成熟性畸胎瘤 病理特征:免疫组化 

分 类 号：R737.31[医药卫生—肿瘤]