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由皮样囊肿衍生的甲状腺滤泡状癌:青年女性罕见的恶性肿瘤,并文献复习。

Follicular variant of papillary thyroid carcinoma arising from a dermoid cyst: a rare malignancy in young women and review of the literature.

机构信息

Department of Gynecology and Obstetrics, Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

Taiwan J Obstet Gynecol. 2012 Sep;51(3):421-5. doi: 10.1016/j.tjog.2012.07.019.

Abstract

OBJECTIVE

Benign or mature cystic teratomas, also known as dermoid cysts, are composed of mature tissues, which can contain elements of all three germ cell layers. Malignant transformation of a mature cystic teratoma is more common in postmenopausal women, however, it can also, rarely, be identified in younger women. We present a case of a 19-year-old woman with malignant transformation of an ovarian mature cystic teratoma.

CASE REPORT

Our case was a 19-year-old woman, who was diagnosed postoperatively with follicular variant of papillary thyroid carcinoma in a mature cystic teratoma. She underwent right cystectomy for adnexal mass. Postoperative metastatic workup revealed a non-metastatic disease and the patient did not undergo any further treatment. After 2 months, a near-total thyroidectomy was performed. Serum thyroglobulin levels were monitored on follow-up and the patient is asymptomatic.

CONCLUSION

Malignant transformation of a dermoid cyst is a rare ovarian neoplasm. We believe that unilateral oophorectomy or cystectomy is a reasonable treatment option for cases in which there is no evidence of capsular invasion, vascular invasion or gross metastasis, and preservation of fertility is desired. Total thyroidectomy was diagnosed in selected cases. Serial serum thyroglobulin should be used as a tumor marker for follow-up.

摘要

目的

良性或成熟囊性畸胎瘤,又称皮样囊肿,由成熟组织构成,可包含三个胚层的成熟细胞。绝经后妇女更易发生成熟囊性畸胎瘤恶变,但在年轻女性中也罕见发生。我们报告一例卵巢成熟囊性畸胎瘤恶变。

病例报告

我们的病例为 19 岁女性,术后诊断为成熟囊性畸胎瘤中的滤泡型乳头状甲状腺癌。因附件包块行右侧附件切除术。术后转移灶检查未发现转移,患者未接受进一步治疗。2 个月后行近全甲状腺切除术。随访时监测血清甲状腺球蛋白水平,患者无症状。

结论

皮样囊肿恶变是一种罕见的卵巢肿瘤。我们认为对于无包膜侵犯、血管侵犯或肉眼转移证据且希望保留生育能力的病例,单侧卵巢切除术或附件切除术是合理的治疗选择。对于选择的病例,可诊断为全甲状腺切除术。连续检测血清甲状腺球蛋白可作为随访的肿瘤标志物。

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