Department of Obstetrics and Gynecology, Hôpital Fribourgeois , Fribourg , Switzerland.
Argot Laboratory Lausanne, Department of Pathology and Cytology , Lausanne , Switzerland.
Front Oncol. 2014 May 9;4:97. doi: 10.3389/fonc.2014.00097. eCollection 2014.
In this article, we present two case reports. The first case was a malignant germ cell tumor of the right ovary in a 23-year old woman and the second case was a bilateral undifferentiated granulosa cell tumor in a 71-year old woman. The aim of these reports is to illustrate the interest of the immunohistochemical analysis to define the correct diagnosis, to better classify these ovarian tumors and improve their management.
In this study, we report two cases. The first case concerns a 23-year old woman (A) with a mixed germ cell tumor of the right ovary [dysgerminoma (75%), yolk sac tumor (20%), and a mature teratoma (5%)], and the second case concerns a 71-year old woman (B) with a bilateral non-differentiated and necrotic granulosa cell tumor of both ovaries. The staging system was used according to both the classifications: International Federation of Gynaecology and Obstetrics 1987 for ovarian cancer and TNM code 2009.
The immunostaining establishes the malignancy and the immunochemistry contributes to confirm effectively the right diagnosis (Tables 2 and 3).
An immunohistochemical analysis is mandatory for the choice of chemotherapy to obtain a better response of the disease and improve the survival prognosis. The efficiency of the chemotherapy authorizes a conservative surgery including a unilateral salpingo-oophorectomy preserving fertility (A). Concerning the non-dysgerminoma tumor (B), and after a surgical staging and debulking, chemotherapy was recommended. The type of tumor and its histological feature conditioned the choice of treatment. The benefit of the immunohistological analysis in this case allowed the right adjuvant treatment.
本文介绍了两例病例报告。第一个病例为 23 岁女性右侧卵巢恶性生殖细胞肿瘤，第二个病例为 71 岁女性双侧未分化颗粒细胞瘤。这些报告的目的是说明免疫组织化学分析对于确定正确诊断、更好地对这些卵巢肿瘤进行分类以及改善其治疗的重要性。
本研究报告了两例病例。第一个病例为 23 岁女性（A）右侧卵巢混合生殖细胞肿瘤[胚胎瘤（75%）、卵黄囊瘤（20%）和成熟畸胎瘤（5%）]，第二个病例为 71 岁女性（B）双侧未分化坏死性颗粒细胞瘤。分期系统根据两种分类方法使用：1987 年国际妇产科联合会卵巢癌分类和 2009 年 TNM 编码。
免疫染色确立了恶性肿瘤，免疫化学有助于有效确认正确诊断（表 2 和 3）。
为了获得更好的疾病反应和改善生存预后，必须进行免疫组织化学分析以选择化疗。化疗的有效性授权进行保留生育能力的单侧附件切除术的保守性手术（A）。对于非胚胎瘤肿瘤（B），在进行手术分期和减瘤后，建议进行化疗。肿瘤类型及其组织学特征决定了治疗选择。在这种情况下，免疫组织化学分析的益处允许进行正确的辅助治疗。
