Bell D A, Scully R E
Department of Pathology, Harvard Medical School, Boston, MA.
Hum Pathol. 1990 Apr;21(4):397-403. doi: 10.1016/0046-8177(90)90201-f.
The clinicopathologic features of 21 cases of otherwise typical serous borderline tumors that contained small foci of stromal invasion were reviewed. The mean age of the patients was 43 years and six of them were pregnant at the time of diagnosis. Nineteen tumors were stage I, one was stage III (para-aortic lymph node involvement) and one was stage IV (parenchymal liver metastasis). The tumor invaded the stroma predominantly as individual cells or nests or clusters of cells with abundant eosinophilic cytoplasm (17 cases), as small confluent nests with a cribriform pattern (two cases) and as rounded aggregates of papillae (two cases). Seven women were treated with bilateral salpingo-oophorectomy and hysterectomy; 13 had less than bilateral oophorectomy. Of the 17 patients for whom followup data were available, 16 were without evidence of disease 1 to 11 (mean, 5.2) years postoperatively, and one patient had a serous borderline tumor with microinvasion in a conserved contralateral ovary 2.8 years postoperatively, but was well 6 months after a partial oophorectomy. These data suggest that serous borderline tumors with microinvasion have a prognosis similar to that of the usual serous borderline tumor, and that conservation of the contralateral ovary and uterus may be acceptable therapy in young women who wish to preserve their fertility.
对21例具有小灶性间质浸润的典型浆液性交界性肿瘤的临床病理特征进行了回顾性分析。患者的平均年龄为43岁，其中6例在诊断时处于妊娠状态。19例肿瘤为Ⅰ期，1例为Ⅲ期（腹主动脉旁淋巴结受累），1例为Ⅳ期（肝实质转移）。肿瘤主要以单个细胞、细胞巢或细胞簇的形式浸润间质，细胞具有丰富的嗜酸性细胞质（17例），以小的融合巢状伴筛状结构的形式浸润（2例），以圆形乳头聚集体的形式浸润（2例）。7名女性接受了双侧输卵管卵巢切除术和子宫切除术；13名女性的手术范围小于双侧卵巢切除术。在有随访数据的17例患者中，16例在术后1至11年（平均5.2年）无疾病证据，1例患者在术后2.8年在保留的对侧卵巢出现微浸润性浆液性交界性肿瘤，但在部分卵巢切除术后6个月情况良好。这些数据表明，伴有微浸润的浆液性交界性肿瘤的预后与普通浆液性交界性肿瘤相似，对于希望保留生育能力的年轻女性，保留对侧卵巢和子宫可能是可接受的治疗方法。
