Chang Y-L, Wu C-T, Lee Y-C
Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
J Thorac Oncol. 2006 Sep;1(7):729-31.
We report an unusual case of gastrointestinal adenocarcinoma arising in a giant posterior mediastinal mature cystic teratoma extending into the retroperitoneum, which was treated by complete excision with a good outcome for more than 2 years. Teratomas with malignant transformation are rare non-germ cell malignant tumors arising from a preexisting mature teratoma. Histological examination revealed that the cyst wall was composed of mature ectodermal, mesodermal, and endodermal elements. Neoplastic glands with a cribriform pattern were found in a small, solid nodule. Strong cytokeratin 20 cytoplasmic immunostaining of the tumor cells supported the diagnosis of gastrointestinal adenocarcinoma. In this report, we describe the potential aggressiveness of a giant mature cystic teratoma with adenocarcinoma and suggest that complete surgical resection without adjuvant chemotherapy be considered as a therapy in the treatment of teratoma with focal malignant transformation.
我们报告了一例罕见的胃肠道腺癌病例，该腺癌起源于一个巨大的后纵隔成熟囊性畸胎瘤，该畸胎瘤延伸至腹膜后，通过完整切除进行治疗，术后两年多效果良好。伴有恶性转化的畸胎瘤是罕见的非生殖细胞恶性肿瘤，由先前存在的成熟畸胎瘤发展而来。组织学检查显示，囊肿壁由成熟的外胚层、中胚层和内胚层成分组成。在一个小的实性结节中发现了具有筛状结构的肿瘤性腺管。肿瘤细胞强烈的细胞角蛋白20细胞质免疫染色支持胃肠道腺癌的诊断。在本报告中，我们描述了伴有腺癌的巨大成熟囊性畸胎瘤的潜在侵袭性，并建议在治疗有局灶性恶性转化的畸胎瘤时，应考虑完整手术切除而不进行辅助化疗。
