起源于卵巢皮样囊肿的单克隆性癌肉瘤：一例报告
Carcinosarcoma of monoclonal origin arising in a dermoid cyst of ovary: a case report.
作者信息
Cabibi Daniela, Martorana Anna, Cappello Francesco, Barresi Elisa, Di Gangi Claudio, Rodolico Vito
机构信息
Istituto di Anatomia Patologica, Facoltà di Medicina, Università degli Studi di Palermo, Italy.
出版信息
BMC Cancer. 2006 Mar 1;6:47. doi: 10.1186/1471-2407-6-47.
BACKGROUND
Transformation of a cystic benign teratoma of the ovary into a "carcinosarcoma" has very rarely been reported and its histogenetic origin is still debated.
CASE PRESENTATION
A case of carcinosarcoma arising from a dermoid cyst is reported. The tumor showed cystic areas delimited by normal squamous epithelium, with transitional areas through dysplastic epithelium to "in situ" and infiltrating squamous cell carcinoma (SCC). The sarcomatous component showed compact tissue composed of round cells concentrically arranged around small vessels, spindle, and pleomorphic cells with a high nuclear-cytoplasmic ratio. Positive staining for vimentin, alpha smooth muscle actin and CD10, as well as P53 and P63, was found in the sarcomatous component and in some atypical basal cells of the squamous epithelium, which also showed the usual epithelial markers.
CONCLUSION
To the best of our knowledge, this is the first case of carcinosarcoma arising from a dermoid cyst in which a histogenetic origin from totipotent stem cells, located in the basal squamous layer, is supported by immunohistochemical findings.
背景
卵巢囊性成熟畸胎瘤转变为“癌肉瘤”的情况鲜有报道，其组织发生学起源仍存在争议。
病例报告
本文报道了一例由皮样囊肿发生的癌肉瘤病例。肿瘤表现为有正常鳞状上皮界定的囊性区域，有从发育异常上皮到“原位”及浸润性鳞状细胞癌（SCC）的移行区域。肉瘤成分显示为由围绕小血管同心排列的圆形细胞、梭形细胞和核质比高的多形性细胞组成的致密组织。在肉瘤成分及鳞状上皮的一些非典型基底细胞中发现波形蛋白、α平滑肌肌动蛋白和CD10以及P53和P63呈阳性染色，这些细胞也显示出常见的上皮标记物。
结论
据我们所知，这是首例由皮样囊肿发生的癌肉瘤病例，免疫组化结果支持其起源于位于鳞状基底层的全能干细胞。
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