原发性卵巢甲状腺肿类癌5例临床病理分析并文献复习  

Clinicopathological analysis and literature review of 5 cases of primary ovarian strumal carcinoid

作　　者：蒋冰晶 傅健飞[2] 郑红娟 陈真伟 胡斌 王利霞 陈春艳 袁瑛[4] Jiang Bing-Jing;Fu Jian-Fei;Zheng Hong-Juan;Chen Zhen-Wei;Hu Bin;Wang Li-Xia;Chen Chun-Yan;Yuan Ying(Department of Pathology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua,Zhejiang 321000,China;Department of Medical Oncology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua,Zhejiang 321000,China;Department of Pathology,Dongyang People’s Hospital,Dongyang,Zhejiang 322100,China;Department of Medical Oncology,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang 310000,China)

机构地区：[1]浙江大学医学院附属金华医院病理科,浙江金华321000 [2]浙江大学医学院附属金华医院肿瘤内科,浙江金华321000 [3]东阳市人民医院病理科,浙江金华322100 [4]浙江大学医学院附属第二医院肿瘤内科,浙江杭州310000

出　　处：《解放军医学杂志》2022年第11期1144-1151,共8页Medical Journal of Chinese People's Liberation Army

摘　　要：目的报道5例原发性卵巢甲状腺肿类癌的临床病理特征及治疗方式并进行文献复习,以提高对该病的认识。方法回顾性分析2009年1月-2020年12月浙江大学医学院附属金华医院收治的3例及东阳市人民医院收治的2例原发性卵巢甲状腺肿类癌患者的临床资料、镜下形态、免疫组织化学表型。结合文献报道的28例患者,总结原发性卵巢甲状腺肿类癌的临床病理特点及治疗方式。结果例1和例5为原发性卵巢甲状腺肿类癌,例2和例4为原发性卵巢甲状腺肿类癌合并囊性畸胎瘤(其中例2尚伴黏液型类癌),例3为原发性卵巢甲状腺肿类癌伴黏液型类癌。5例患者甲状腺肿类癌的甲状腺滤泡成分免疫组织化学染色均呈甲状腺标记物阳性,类癌成分免疫组织化学染色均呈神经内分泌标记物及生长抑素受体2(SSTR2)阳性,例2和例3中黏液型类癌均呈突触素(Syn)阳性、嗜铬素A(CgA)阳性、CDX2阳性。5例患者肿瘤Ki-67增殖指数均<2%。此外,5例患者的甲状腺滤泡不同程度地表达神经内分泌标记物。4例术后随访未发现肿瘤复发转移,1例失访。在PubMed和SEER数据库分别检索了1971-2021年和1988-2011年报道的原发性卵巢甲状腺肿类癌病例,共28例,患者平均年龄分别为51岁和46岁,除1例出现淋巴结转移和1例死亡外,其余在随访期间均未发现肿瘤复发转移。结论原发性卵巢甲状腺肿类癌是一种罕见的卵巢肿瘤,部分病例可伴囊性畸胎瘤及黏液型类癌,常缺少典型的临床表现,病理取材及诊断时应避免漏诊。Ⅰ期患者可选择保留更多脏器功能的手术方式,预后较好,但需长期随访以排除复发及隐匿转移。Objective To report the clinicopathological features and treatment of 5 cases of primary ovarian strumal carcinoid and review the literature for improving the understanding to this disease.Methods The clinical data of 5 cases of primary ovarian strumal carcinoid collected in the Affiliated Jinhua Hospital,Zhejiang University School of Medicine(3 cases)and Dongyang People's Hospital(2 cases)from January 2009 to December 2020,and retrospectively analyzed by clinical features,microscopic appearance and immunohistochemical stains.The clinicopathological features and treatment methods of primary ovarian strumal carcinoid were summarized based on combined literature reports and retrieval of relevant literature databases of 28 patients.Results Case 1 and case 5 were primary ovarian strumal carcinoid,case 2 and case 4 were primary ovarian strumal carcinoid mixed with cystic teratoma.In addition,mucinous carcinoid was also seen in case 2.Case 3 was primary ovarian strumal carcinoid mixed with mucinous carcinoid.Immunohistochemical found the thyroid follicles of all the 5 cases were positive for thyroid markers,the carcinoid components were positive for neuroendocrine markers and somatostatin receptor 2(SSTR2).Mucinous carcinoid of both case 2 and case 3 were positive for synaptophysin(Syn),chromogranin A(CgA)and caudal type homeobox transcription factor 2(CDX2).The Ki-67 proliferation index of all the 5 cases were less than 2%.In addition,the thyroid follicles of 5 cases also showed different levels of expression for neuroendocrine markers.During follow-up,4 cases showed no recurrence or metastasis,and one case lost.A total of 28 cases of primary ovarian strumal carcinoid were searched in PubMed from 1971 to 2021 and SEER database from 1988 to 2011.The mean age of the patients was 51 and 46 years old.Except for one case of lymph node metastasis and one case of death,no tumor recurrence and metastasis were found during follow-up.Conclusions Primary ovarian strumal carcinoid is a kind of rare ovarian tumor.Some cases can be

关 键 词：卵巢肿瘤 甲状腺肿类癌 神经内分泌肿瘤 

分 类 号：R711.75[医药卫生—妇产科学]