Kapp D S, Kohorn E I, Merino M J, LiVolsi V A
Gynecol Oncol. 1985 Feb;20(2):234-44. doi: 10.1016/0090-8258(85)90146-5.
Pure ovarian dysgerminomas with associated elevation of human chorionic gonadotropin (hCG) are rare, and their optimum management is unclear. We report here a 24-year-old woman with stage III dysgerminoma of the ovaries, with bulky intrapelvic disease, paraaortic adenopathy, and elevated pre- and postsurgical serum beta-hCG titers. Following administration of whole abdominal-pelvic and mediastinal irradiation therapy, the patient's adenopathy regressed, her serial beta-hCG titers returned to normal, and she has remained free of disease for the past 30 months. Histopathological studies revealed a pure dysgerminoma with scattered giant cells which were negative for hCG by immunoperoxidase staining. The literature is reviewed with reference to the significance of elevated hCG levels, the presence of giant cells in association with dysgerminoma of the ovary, and therapeutic implications. Serial determinations of beta-hCG titers may prove to be as valuable in the management of these patients as they are in patients with testicular tumors.
伴有人绒毛膜促性腺激素（hCG）升高的纯卵巢无性细胞瘤很罕见，其最佳治疗方案尚不清楚。我们在此报告一名24岁患有Ⅲ期卵巢无性细胞瘤的女性，盆腔内有巨大肿块，腹主动脉旁淋巴结肿大，术前和术后血清β-hCG水平均升高。在接受全腹盆腔及纵隔放射治疗后，患者的淋巴结肿大消退，连续的β-hCG水平恢复正常，并且在过去30个月里一直无病生存。组织病理学研究显示为纯无性细胞瘤，伴有散在的巨细胞，免疫过氧化物酶染色显示这些巨细胞hCG呈阴性。本文结合hCG水平升高的意义、卵巢无性细胞瘤中巨细胞的存在情况以及治疗意义对相关文献进行了综述。连续测定β-hCG水平在这些患者的管理中可能与在睾丸肿瘤患者中一样有价值。
