-
卵巢黏液性交界性肿瘤(mucinous borderline tumor,MBT)占卵巢上皮性肿瘤的10%~15%[1],其生长方式和细胞学特征介于良性囊腺瘤与恶性浸润癌之间。卵巢成熟性囊性畸胎瘤(mature cystic teratoma,MCT)是卵巢最常见的良性肿瘤,占所有卵巢肿瘤的20%以上[2],又被称为皮样囊肿或卵巢皮样瘤。两种肿瘤并存于同侧卵巢的病例非常罕见,本文报道了1例52岁的绝经后女性经组织病理学检查诊断为右侧卵巢MBT合并MCT的病例,并结合文献对其临床及影像学表现进行回顾总结。
同侧卵巢黏液性交界性肿瘤合并成熟性囊性畸胎瘤一例并文献复习
Mucinous borderline tumor and mature cystic teratoma arising in the same ovary: a case report and literature review
-
摘要: 笔者报道了1例同侧卵巢发生黏液性交界性肿瘤(MBT)合并成熟性囊性畸胎瘤(MCT)的病例,从临床症状、实验室检查、影像学表现及病理诊断等方面综合分析了其特点,并通过文献复习总结了该病的影像学表现。MBT和MCT均为卵巢的常见肿瘤,但两种不同性质的肿瘤并存于同侧卵巢非常罕见,其临床表现无特异性,影像学检查若在同一肿块中发现两种肿瘤类型的典型影像学表现,且不能用一种肿瘤解释时,应该考虑同时存在另一种肿瘤的可能。Abstract: A rare case of mucinous borderline tumor (MBT) and mature cystic teratoma (MCT) arising in the same ovary was reported. The characteristics of this case were comprehensively analyzed according to clinical symptoms, laboratory examinations, imaging findings and pathological diagnosis. The imaging features of the disease were summarized through literature review. MBT and MCT are common ovarian tumors, but it is very rare that two different types of tumor coexist in the same ovary. Its clinical manifestations are non-specific. When two types of typical imaging findings of different tumors are present in the same ovary, the possibility of the presence of another tumor should be considered.
-
Key words:
-
[1] Ludovisi M, Foo X, Mainenti S, et al. Ultrasound diagnosis of serous surface papillary borderline ovarian tumor: a case series with a review of the literature[J]. J Clin Ultrasound, 2015, 43(9): 573−577. DOI: 10.1002/jcu.22266. [2] Bozdağ Z, Tepe NB. Malignant transformation of mature cystic teratomas: a retrospective analysis of 181 cases[J]. Eur J Ther, 2020, 26(1): 31−35. DOI: 10.5152/EurJTher.2020.19108. [3] Zhang FT, Yu XL, Zeng J, et al. Mucinous tumor arising in a giant sacrococcygeal teratoma: a rare case report[J/OL]. Medicine (Baltimore), 2017, 96(47): e8759[2020-06-30]. https://journals.lww.com/md-journal/Fulltext/2017/11270/Mucinous_tumor_arising_in_a_giant_sacrococcygeal.64.aspx. DOI: 10.1097/MD.0000000000008759. [4] Hwang JH, So KA, Modi G, et al. Borderline-like mucinous tumor arising in mature cystic teratoma of the ovary associated with pseudomyxoma peritonei[J]. Int J Gynecol Pathol, 2009, 28(4): 376−380. DOI: 10.1097/PGP.0b013e318191e766. [5] Elias KM, Tsantoulis P, Tille JC, et al. Primordial germ cells as a potential shared cell of origin for mucinous cystic neoplasms of the pancreas and mucinous ovarian tumors[J]. J Pathol, 2018, 246(4): 459−469. DOI: 10.1002/path.5161. [6] Wang YH, Shwartz LE, Anderson D, et al. Molecular analysis of ovarian mucinous carcinoma reveals different cell of origins[J/OL]. Oncotarget, 2015, 6(26): 22949−22958[2020-06-30]. https://www.oncotarget.com/article/5146/text. DOI: 10.18632/oncotarget.5146. [7] Kerr SE, Flotte AB, McFalls MJ, et al. Matching maternal isodisomy in mucinous carcinomas and associated ovarian teratomas provides evidence of germ cell derivation for some mucinous ovarian tumors[J]. Am J Surg Pathol, 2013, 37(8): 1229−1235. DOI: 10.1097/PAS.0b013e31828f9ecb. [8] Delić R. Mucinous cystadenoma of the ovary with carcinoid tumour in a 23-year-old nulliparous woman[J]. J Obstet Gynaecol, 2017, 37(4): 543−544. DOI: 10.1080/01443615.2016.1274294. [9] Barghi A, Wu M, Nguyen V, et al. Minimally invasive drainage of a giant ovarian mucinous cystadenoma associated with a mature cystic teratoma[J/OL]. J Surg Case Rep, 2018, 2018(11): rjy322[2020-06-30]. https://academic.oup.com/jscr/article/2018/11/rjy322/5222695. DOI: 10.1093/jscr/rjy322. [10] 王欢, 马法库, 李双明, 等. 卵巢成熟型囊性畸胎瘤合并类癌及黏液性囊腺癌1例报告[J]. 中国肿瘤临床, 2015, 42(3): 196. DOI: 10.3969/j.issn.1000-8179.20141856.
Wang H, Ma FK, Li SM, et al. Mature cystic teratoma of the ovary accompanied by carcinoid and mucinous cystadenocarcinoma: a case report[J]. Chin J Clin Oncol, 2015, 42(3): 196. DOI: 10.3969/j.issn.1000-8179.20141856.[11] Chen JM, Gao HY, Wang Q, et al. Expression and clinical significance of tumor markers in ovarian mature cystic teratoma[J/OL]. Clin Exp Obstet Gynecol, 2016, 43(3): 397−400[2020-06-30]. https://pubmed.ncbi.nlm.nih.gov/27328499. DOI: 10.12891/ceog2128.2016. [12] Srisajjakul S, Prapaisilp P, Bangchokdee S. Imaging features of unusual lesions and complications associated with ovarian mature cystic teratoma[J]. Clin Imag, 2019, 57: 115−123. DOI: 10.1016/j.clinimag.2019.05.013. [13] Ravikanth R. A rare case of collision tumor: MASSIVE mucinous cystadenoma and benign mature cystic teratoma arising in the same ovary[J]. CHRISMED J Health Res, 2017, 4(3): 201−203. DOI: 10.4103/cjhr.cjhr_20_17. [14] 陈超坤, 刘亮, 傅飞先, 等. 囊性胸腺瘤和囊性畸胎瘤的影像学特征及鉴别诊断[J]. 国际放射医学核医学杂志, 2016, 40(1): 31−34. DOI: 10.3760/cma.j.issn.1673-4114.2016.01.007.
Chen CK, Liu L, Fu FX, et al. Imaging features and differential diagnosis of cystic thymoma and cystic teratoma[J]. Int J Radiat Med Nucl Med, 2016, 40(1): 31−34. DOI: 10.3760/cma.j.issn.1673-4114.2016.01.007.[15] Peng Y, Lin JH, Guan J, et al. Ovarian collision tumors: imaging findings, pathological characteristics, diagnosis, and differential diagnosis[J/OL]. Abdom Radiol (NY), 2018, 43(8): 2156−2168[2020-06-30]. https://link.springer.com/article/10.1007/s00261-017-1419-6. DOI: 10.1007/s00261-017-1419-6. [16] Fujii K, Yamashita Y, Yamamoto T, et al. Ovarian mucinous tumors arising from mature cystic teratomas— a molecular genetic approach for understanding the cellular origin[J]. Hum Pathol, 2014, 45(4): 717−724. DOI: 10.1016/j.humpath.2013.10.031. [17] Vang R, Gown AM, Zhao CQ, et al. Ovarian mucinous tumors associated with mature cystic teratomas: morphologic and immunohistochemical analysis identifies a subset of potential teratomatous origin that shares features of lower gastrointestinal tract mucinous tumors more commonly encountered as secondary tumors in the ovary[J]. Am J Surg Pathol, 2007, 31(6): 854−869. DOI: 10.1097/PAS.0b013e31802efb45.