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目的探讨性腺外畸胎瘤临床病理特征。方法参照WHO(1999)卵巢肿瘤组织学分型标准对172例手术切除的性腺外畸胎瘤的临床和病理特征进行回顾性研究。结果172例性腺外畸胎瘤患者男性85例(49.4%),女性87例(50.6%),男女之比约为1∶1;35岁以下患者131例(76.2%);肿瘤主要发生在身体中线部位,频率依次为纵隔、椎管内、颅内、骶尾部、腹膜后、肠系膜及下腹部等。172例畸胎瘤中18例(10.5%)为恶性,其患者男女之比为1.6∶1;发生频率依次为颅内、纵隔、骶尾部、椎管内、肝、腹膜后、下腹部。18例恶性畸胎瘤中7例为完全由胚胎性组织构成的未成熟性畸胎瘤,另11例为成熟性或未成熟性畸胎瘤合并其他类型生殖细胞肿瘤或伴有腺癌等恶性成分。结论性腺外畸胎瘤有以下特点:①多发生在身体中线两旁;②好发于小儿、青年,男性患者恶性率高于女性;③恶性率较高,尤以颅内畸胎瘤恶性多见;④未成熟性畸胎瘤多合并其他生殖细胞瘤成分;⑤可能有不同于性腺畸胎瘤的发生机制。
Objective To investigate the clinicopathological features of extragonadal teratoma. Methods The clinical and pathological features of 172 extragonadal teratomas treated by WHO (1999) ovarian tumor histological classification were retrospectively studied. Results There were 85 male patients (49.4%) and 87 female patients (50.6%) in 172 cases of extragonadal teratoma. The ratio of male to female was about 1: 1. There were 131 cases (76.2%) under 35 years old. The tumors mainly occurred in the body The midline site, followed by the mediastinum, spinal canal, intracranial, sacrococcygeal, retroperitoneal, mesentery and lower abdomen. In 172 cases of teratoma, 18 cases (10.5%) were malignant and the ratio of male to female was 1.6:1. The frequency of occurrence was intracranial, mediastinal, sacrococcygeal, intraspinal, liver, retroperitoneum and lower abdomen. Of 18 malignant teratomas, 7 were immature teratomas entirely composed of embryonic tissue and the other 11 were malignant tumors of mature or immature teratoma with other types of germ cell tumors or with adenocarcinoma ingredient. Conclusion Extragonadal teratoma has the following characteristics: ① occur in the body midline on both sides; ② occur in children, young, male patients with higher malignant rate than women; ③ higher malignant rates, especially malignant intracranial teratoma more common ; ④ immature teratoma and other components of other germ cell tumors; ⑤ may have different from the mechanism of gonadal teratoma.