Koo Hyun-Lyoung, Choi Jene, Kim Kyu-Rae, Kim Jong-Hyuk
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Pathol Int. 2006 Oct;56(10):613-6. doi: 10.1111/j.1440-1827.2006.02016.x.
Pure primary ovarian choriocarcinoma is a rare condition that can be of gestational or non-gestational origin. Non-gestational choriocarcinoma has been found to be resistant to single-agent chemotherapy and has a worse prognosis than gestational choriocarcinoma, but it is difficult to distinguish the two types by routine histological examination. Herein is reported a case of primary pure non-gestational choriocarcinoma of the ovary in a 33-year-old nulligravid woman, as confirmed by DNA polymorphism analysis. All tested microsatellite markers had identical DNA profiles with the same allelic sizes between the tumor and the myometrium of the patient, who was homozygous for three markers (BAT26, BAT25 and D17S250) and heterozygous for four (D2S123, D18S57, DCC and D18S58), supporting non-gestational origin. The patient has no evidence of disease 17 months after surgery and four cycles of combination chemotherapy. This case demonstrates the usefulness of DNA polymorphism analysis for the determination of the origin of extrauterine choriocarcinoma. Clinical relevance of this method needs to be further studied and substantiated.
纯原发性卵巢绒毛膜癌是一种罕见疾病，可起源于妊娠或非妊娠。已发现非妊娠性绒毛膜癌对单药化疗耐药，且预后比妊娠性绒毛膜癌差，但通过常规组织学检查很难区分这两种类型。本文报道了一例33岁未孕女性的原发性纯非妊娠性卵巢绒毛膜癌病例，经DNA多态性分析确诊。所有检测的微卫星标记在肿瘤与患者子宫肌层之间具有相同的DNA图谱和等位基因大小，患者三个标记（BAT26、BAT25和D17S250）为纯合子，四个（D2S123、D18S57、DCC和D18S58）为杂合子，支持非妊娠起源。患者在手术及四个周期联合化疗后17个月无疾病证据。该病例证明了DNA多态性分析在确定宫外绒毛膜癌起源方面的有用性。该方法的临床相关性需要进一步研究和证实。
