Department of Diagnostic Imaging, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Can Assoc Radiol J. 2010 Feb;61(1):23-8. doi: 10.1016/j.carj.2009.07.001.
Germ cell tumours are the most common ovarian neoplasms in childhood and, of these, teratomas, whether mature or immature, are the most frequently found. Mature teratoma is a benign tumour, whereas the immature type, although also benign, has a more aggressive course, with a propensity to recurrence. A review of the literature revealed that there are some imaging features that may help to differentiate between these 2 types of teratoma, although no systematic comparison has been made. The objective of this study was to review imaging features of ovarian teratomas in children and to assess differentiating imaging features between the mature and immature types of ovarian teratoma.
Retrospective analysis of all patients who presented to our institution during a 9-year period (September 1999 to August 2008) with ovarian teratoma as confirmed on histology.
Forty-one patients with pathologically proven ovarian teratoma were found. The patient ages ranged from 4-18 years at presentation (mean [standard deviation] age, 12.4 +/- 3.4 years; median age, 13 years). Thirty patients (73.2%) were found to have mature ovarian teratoma, and 11 (26.8%) had immature teratoma. A component of endodermal sinus tumour was found in one of the immature teratomas. On ultrasonography, the appearance of the immature teratomas was purely solid in 3 (27.3%), mixed solid and cystic in 6 (54.5%), and predominantly cystic in 2 (18%). The mature ovarian teratomas demonstrated a predominantly cystic appearance in 22 (73.3%) and a mixed solid and cystic appearance in 8 (26.6%); there were no cases with a pure solid appearance. The prevalence of the more cystic appearance of the mature type showed significant statistical difference when compared with its prevalence in the immature type (P = .0008, chi(2) test). Other imaging features, such as size, presence of fat, or calcifications, did not show a significant difference between the 2 types of teratoma.
The predominance of a cystic component and a pure solid component in ovarian teratoma are significant differentiating factors between the mature type and the more aggressive immature type of teratoma.
生殖细胞肿瘤是儿童期最常见的卵巢肿瘤，其中成熟或不成熟畸胎瘤最为常见。成熟畸胎瘤是一种良性肿瘤，而不成熟型虽然也是良性的，但具有更具侵袭性的病程，容易复发。文献回顾显示，存在一些影像学特征可能有助于区分这两种类型的畸胎瘤，尽管尚未进行系统比较。本研究的目的是回顾儿童卵巢畸胎瘤的影像学特征，并评估成熟型和不成熟型卵巢畸胎瘤之间的影像学特征差异。
对 1999 年 9 月至 2008 年 8 月期间在我院就诊的所有经组织病理学证实为卵巢畸胎瘤的患者进行回顾性分析。
共发现 41 例经病理证实的卵巢畸胎瘤患者。患者年龄在 4-18 岁之间（平均年龄[标准差]为 12.4 +/- 3.4 岁；中位数年龄为 13 岁）。30 例（73.2%）为成熟型卵巢畸胎瘤，11 例（26.8%）为不成熟型畸胎瘤。在 1 例不成熟畸胎瘤中发现内胚窦瘤成分。超声检查显示，3 例（27.3%）不成熟畸胎瘤呈单纯实性，6 例（54.5%）呈实性和囊性混合，2 例（18%）呈囊性为主。22 例（73.3%）成熟型卵巢畸胎瘤表现为单纯囊性，8 例（26.6%）表现为实性和囊性混合；无单纯实性表现。成熟型的囊性外观更为常见，与不成熟型相比差异有统计学意义（P =.0008，卡方检验）。其他影像学特征，如大小、脂肪存在或钙化，在两种类型的畸胎瘤之间无显著差异。
卵巢畸胎瘤中囊性成分和单纯实性成分的优势是成熟型与侵袭性更强的不成熟型畸胎瘤之间的显著鉴别因素。
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