Miyamoto M, Takano M, Goto T, Kato M, Sasaki N, Furuya K
Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Japan.
Eur J Gynaecol Oncol. 2012;33(4):414-8.
Malignant transformation of ovarian mature cystic teratoma is rare, and occurs in approximately 1% of all cases. The most common histology arising in mature cystic teratoma is squamous cell carcinoma. Less frequently, malignant transformation is represented by an endocrine tumor. To date, only five cases of large cell neuroendocrine carcinoma (LCNC) arising in a mature cystic teratoma of the ovary have been reported.
A 69-year-old woman presented with a 15-cm left ovarian mass, and was diagnosed with Stage IV large cell carcinoma neuroendocrine carcinoma (LCNC) arising in mature cystic teratoma (MCT) of the left ovary. The patient received adjuvant chemotherapy with paclitaxel and carboplatin, however, residual tumors increased in size. Six months after the debulking surgery she succumbed to the disease. A literature review revealed LCNC of the ovary showed excessively aggressive phenotype in malignant transformation from ovarian mature cystic teratoma.
The present case of LCNC arising in MCT had an exceedingly poor prognosis, which was suggested in the previous five cases reported.
卵巢成熟囊性畸胎瘤恶变罕见,约占所有病例的1%。成熟囊性畸胎瘤最常见的组织学类型是鳞状细胞癌。较少见的情况下,恶变表现为内分泌肿瘤。迄今为止,仅有5例卵巢成熟囊性畸胎瘤发生大细胞神经内分泌癌(LCNC)的病例报道。
一名69岁女性因左卵巢有一个15厘米的肿块就诊,被诊断为左卵巢成熟囊性畸胎瘤(MCT)伴发IV期大细胞神经内分泌癌(LCNC)。患者接受了紫杉醇和卡铂辅助化疗,然而,残留肿瘤体积增大。减瘤手术后6个月,她死于该疾病。文献综述显示,卵巢LCNC在卵巢成熟囊性畸胎瘤恶变中表现出过度侵袭性的表型。
本例MCT伴发LCNC预后极差,此前报道的5例病例亦提示如此。