Arai T, Kitayama Y, Koda K
Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Japan.
Int J Gynecol Pathol. 1999 Jul;18(3):277-80. doi: 10.1097/00004347-199907000-00015.
An ovarian mucinous cystadenocarcinoma admixed with a component of yolk sac tumor was encountered in a 71-year-old woman, the first such tumor to be reported. The preoperative serum level of alpha-fetoprotein was elevated (55.6 ng/mL). A right ovarian cystic tumor, 8 cm in maximal dimension, was removed and found to have a solid component. Microscopically, the cystic lesion was a mucinous cystadenocarcinoma, whereas the solid portion was typical yolk sac tumor with microcystic, reticular, and labyrinthine patterns, Schiller-Duval bodies, scattered giant cells with bizarre nuclei, and intracellular and extracellular hyaline globules. There was no evidence of other germ cell tumor components. Yolk sac tumor showed positive reactions for alpha-fetoprotein, carcinoembryonic antigen, and alpha-1-antitrypsin but was negative for CA125, CA19-9, and human chorionic gonadotrophin. The patient died of recurrent tumor 6 months postoperatively without response to combination chemotherapy.
一名71岁女性被诊断为卵巢黏液性囊腺癌合并卵黄囊瘤成分,这是首例此类肿瘤的报告。术前血清甲胎蛋白水平升高(55.6 ng/mL)。切除了一个最大直径为8 cm的右侧卵巢囊性肿瘤,发现其有实性成分。显微镜下,囊性病变为黏液性囊腺癌,而实性部分为典型的卵黄囊瘤,具有微囊、网状和迷路状结构、Schiller-Duval小体、散在的核异形巨细胞以及细胞内和细胞外透明小球。没有其他生殖细胞肿瘤成分的证据。卵黄囊瘤对甲胎蛋白、癌胚抗原和α-1-抗胰蛋白酶呈阳性反应,但对CA125、CA19-9和人绒毛膜促性腺激素呈阴性反应。患者术后6个月死于肿瘤复发,联合化疗无效。