Marinova P, Ivanova R, Veselinova T, Jordanova B
Akush Ginekol (Sofiia). 2015;54(1):44-7.
An ovarian tumor (gynandroblastoma) in a 16-year old girl is reported. Clinical presentation include abdominal pain, signs of virilization and irregular menstrual cycles. Ultrasound scan examination reveals a cystic mass in a left ovary. The patient underwent a left ovariosalpingectomy. Grossly, a cystic mass (73 x 42 x 36 mm) with smooth outer surface and with many cysts was found in the left ovary. The intraoperative diagnosis was ovarian adenocarcinoma. Postoperative histological examination reveals that the tumor was presented by two patterns- nodules and nests of juvenile granulose cell pattern admixed with Sertoli-Leydig pattern as tubules and cyst and scanty Sertoli cells. On immunohistochemical staining the Granulosa cells were negative for cytokeratin AE1-AE3 and positive for Vimentin. The Sertoli cells were androgen receptor positive. A year after operation the patient had no abdominal pain, the menstrual cycles are regular but the virilization persist. Histogenesis and differential diagnosis are discussed.
报告了一名16岁女孩的卵巢肿瘤（两性母细胞瘤）。临床表现包括腹痛、男性化体征和月经周期不规律。超声扫描检查发现左卵巢有一个囊性肿块。患者接受了左侧卵巢输卵管切除术。大体上，在左卵巢发现一个囊性肿块（73×42×36mm），外表面光滑，有许多囊肿。术中诊断为卵巢腺癌。术后组织学检查显示，肿瘤呈现两种模式——青少年颗粒细胞模式的结节和巢状结构，与睾丸支持-间质细胞模式混合，表现为小管、囊肿和少量支持细胞。免疫组化染色显示，颗粒细胞细胞角蛋白AE1-AE3阴性，波形蛋白阳性。支持细胞雄激素受体阳性。术后一年，患者无腹痛，月经周期规律，但男性化体征持续存在。文中讨论了组织发生和鉴别诊断。
