Kushima Miki
Division of Hospital Pathology, Showa University Hospital, Tokyo, Japan.
Pathol Int. 2004 Feb;54(2):139-43. doi: 10.1111/j.1440-1827.2004.01599.x.
An extremely rare adenocarcinoma arising from a mature cystic teratoma is reported. A 58-year-old woman underwent bilateral salpingo-oophorectomy because of a tumor in each ovary. The right ovarian tumor (solid, 9.6 x 9.6 x 6.3 cm) was a benign thecoma. Histology revealed the left ovarian cystic tumor (multilocular, 6.4 x 4.8 x 2.8 cm) was a mature cystic teratoma containing skin, fatty tissue and respiratory epithelial tissue. In addition, there was a small focal adenocarcinomatous lesion contiguous to the teratomatous ciliated columnar epithelium without stromal invasion (so-called adenocarcinoma in situ) that was suggestive of respiratory epithelium origin. However, goblet cells were present in the glandular structures of the lesion and immunohistochemical staining was segmentally strongly positive for CK20 and uniformly negative for CK7. These results suggested that the adenocarcinomatous lesion had a mucin secretory gastrointestinal phenotype. Further investigation and the collection of more cases is necessary to determine the origin and growth mechanism of adenocarcinoma arising from mature cystic teratoma of the ovary.
本文报道了一例极其罕见的起源于成熟囊性畸胎瘤的腺癌。一名58岁女性因双侧卵巢肿瘤接受了双侧输卵管卵巢切除术。右侧卵巢肿瘤（实性，9.6×9.6×6.3 cm）为良性卵泡膜瘤。组织学检查显示，左侧卵巢囊性肿瘤（多房性，6.4×4.8×2.8 cm）为成熟囊性畸胎瘤，包含皮肤、脂肪组织和呼吸上皮组织。此外，在畸胎瘤的纤毛柱状上皮附近有一个小的局灶性腺癌病变，无基质浸润（所谓的原位腺癌），提示起源于呼吸上皮。然而，病变的腺结构中存在杯状细胞，免疫组化染色显示CK20呈节段性强阳性，CK7呈均匀阴性。这些结果表明，该腺癌细胞具有分泌黏液的胃肠道表型。需要进一步研究并收集更多病例，以确定卵巢成熟囊性畸胎瘤腺癌的起源和生长机制。
