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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 and the origin of tumor in mature ovarian cystic teratoma with borderline mucinous tumors. Methods One case of mature ovarian cystic teratoma with mucinous borderline tumor and intraepithelial neoplasia was reviewed. The histological observation and immunohistochemical analysis were performed and the related literatures were reviewed. Results Female patient, 20 years old. CT showed a large ovary on the left, multiple rooms, cystic solid mass, clear boundaries. Giant tumor: tumor size of 18.5 cm × 17 cm × 7 cm, the surface is smooth, local ulceration, mucus flow out of the sticky mouth at the breach, the section of multiple atrial cystic solid cystic part containing mucus-like substances, one of the rooms Filled with sebum hair samples; solid part of the gray, sticky slippery feel. Microscopic examination: intestinal mucosal epithelial cells were stratified, large tumor nuclei, mitotic phenomenon is easy to see, local gland wall or mesh-like, no interstitial infiltration; one of the cysts lined with squamous epithelium , Visible hair follicles, sebaceous glands, sweat glands and other ingredients, and visible gastrointestinal epithelium. Immunohistochemistry: Myxoid epithelial cells CK 7 and CK20 (+). Conclusion Ovarian mature cystic teratoma with mucinous borderline tumors is rare, and intraepithelial carcinogenesis is more rare. Mucinous borderline tumors may originate from the gastrointestinal epithelial component of mature cystic teratoma.