da Silva B B, dos Santos A R, Lopes-Costa P V, Sousa-Júnior E C, Correa-Lima M V, Pires C G
Department of Gynecology, Federal University of Piauí, Teresina, Piauí, Brazil.
Eur J Gynaecol Oncol. 2009;30(2):226-8.
Malignant transformation of ovarian dermoid cysts is rare and spontaneous rupture provoking chemical peritonitis is even rarer. Laparotomy in a 75-year-old Brazilian woman with abdominal pain and signs of peritoneal irritation revealed a voluminous right ovarian cyst with rupture of the capsule, an abundant quantity of fatty material in the abdominal cavity, and signs of peritonitis. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with partial omentectomy were performed. Histopathology confirmed a dermoid cyst with a well-differentiated area of epidermoid carcinoma. The patient refused additional treatment and is currently in the seventh year of follow-up with no signs of recurrence. Rupture of a dermoid cyst of the ovary resulting in chemical peritonitis is very rare and may be associated with malignant transformation.
卵巢皮样囊肿恶变罕见，自发破裂引发化学性腹膜炎则更为罕见。一名75岁腹痛且有腹膜刺激征的巴西女性接受剖腹探查术，发现右侧卵巢有一个巨大囊肿，囊肿包膜破裂，腹腔内有大量脂肪物质及腹膜炎体征。遂行全腹子宫切除术、双侧输卵管卵巢切除术及部分大网膜切除术。组织病理学证实为皮样囊肿，伴有高分化表皮样癌区域。患者拒绝进一步治疗，目前处于随访的第七年，无复发迹象。卵巢皮样囊肿破裂导致化学性腹膜炎非常罕见，可能与恶变有关。
