García-Galvis Olga F, Cabrera-Ozoria Claudia, Fernández José Aneiros, Stolnicu Simona, Nogales Francisco F
Departments of Pathology, University Hospital, Granada, Spain.
Int J Gynecol Pathol. 2008 Oct;27(4):515-20. doi: 10.1097/PGP.0b013e31817b06c7.
This paper reports a unique stage IV complex ovarian carcinosarcoma in a 69-year patient that had malignant mixed müllerian epithelial and mesenchymal components and also other malignant differentiation such as neuroectodermal (small cell, neuroendocrine, neuroglial, neuronal, and melanocytic) and endodermal (yolk sac tumor) tissues and trophoblastic cells. As its phenotype comprised elements derived embryologically from the 3 germ layers, it posed the problem of differentiating it from a teratoma originated from germ cells, with which it shared a trilaminar type differentiation. It was different from a teratoma as it coexisted with, and possibly originated from, a somatic tumor, namely a characteristic endometrioid adenocarcinoma. All neoplastic tissue patterns present in the neoplasm were malignant per se without an apparent gradient of maturation or presence of organoid structures.
本文报告了一名69岁患者的罕见IV期复杂卵巢癌肉瘤，其具有恶性混合苗勒管上皮和间充质成分，还存在其他恶性分化，如神经外胚层（小细胞、神经内分泌、神经胶质、神经元和黑素细胞）和内胚层（卵黄囊瘤）组织以及滋养层细胞。由于其表型包含胚胎学上源自3个胚层的成分，因此存在将其与起源于生殖细胞的畸胎瘤区分开来的问题，二者均具有三层型分化。它与畸胎瘤不同，因为它与一种体细胞肿瘤即特征性子宫内膜样腺癌共存，并且可能起源于此。肿瘤中存在的所有肿瘤组织模式本身均为恶性，没有明显的成熟梯度或类器官结构。
