Hicks M L, Maxwell S L, Kim W
Department of Obstetrics and Gynecology, Henry Ford Hospital.
Henry Ford Hosp Med J. 1990;38(1):76-8.
Endodermal sinus tumor of the ovary occurs primarily in children and young adults. This tumor is classified as a germ cell tumor which comprises approximately 5% of all ovarian tumors. In the past, patients with this highly malignant tumor had low survival. However, with the evolution of effective adjunctive chemotherapeutic regimens, specifically vincristine, actinomycin D, and cyclophosphamide, survival rates have improved. In an attempt to continuously improve survival rates, other combination chemotherapeutic regimens are currently under investigation. Unlike epithelial ovarian malignancies, endodermal sinus tumor can be monitored by a specific tumor marker, alpha-fetoprotein (AFP). Serum levels of AFP can be followed from the preoperative period through the course of chemotherapy. When elevated, AFP has excellent predictability that persistent disease is present. Because this disease presents primarily in young females, preservation of reproductive function is of utmost importance. We report a case of advanced endodermal sinus tumor which was managed with conservative surgery only, followed by radical combination chemotherapy, resulting in preservation of normal reproductive function and total resolution of disease documented by second-look laparotomy.
卵巢内胚窦瘤主要发生于儿童和年轻成人。该肿瘤被归类为生殖细胞肿瘤，约占所有卵巢肿瘤的5%。过去，患有这种高度恶性肿瘤的患者生存率较低。然而，随着有效的辅助化疗方案的发展，特别是长春新碱、放线菌素D和环磷酰胺，生存率有所提高。为了持续提高生存率，目前正在研究其他联合化疗方案。与上皮性卵巢恶性肿瘤不同，内胚窦瘤可以通过一种特定的肿瘤标志物甲胎蛋白（AFP）进行监测。术前至化疗过程中均可监测血清AFP水平。当AFP升高时，对于存在持续性疾病具有极佳的预测性。由于这种疾病主要发生在年轻女性中，保留生殖功能至关重要。我们报告一例晚期内胚窦瘤病例，仅通过保守手术治疗，随后进行根治性联合化疗，结果保留了正常生殖功能，二次剖腹探查证明疾病完全缓解。
