Rubio Alejandro, Schuldt Maolly, Chamorro Clara, Crespo-Lora Vicente, Nogales Francisco F
Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain.
Hospital Jose Carrasco Arteaga del IESS, Cuenca, Republic of Ecuador.
Int J Surg Pathol. 2015 Aug;23(5):388-92. doi: 10.1177/1066896915586254. Epub 2015 May 19.
A bilateral small cell ovarian carcinoma pulmonary-type (SCCOPT), arising in bilateral mature cystic teratomas (MCTs) presented as stage IIIB in a 37-year-old woman. Microscopically, tumor nests were related to the dermoid protuberance and expressed pancytokeratin, EMA, CD56, chromogranin A, NSE, synaptophysin, and SOX2. SALL4 was also focally positive. CDX2, TTF1, PAX8, CK7, CK20, and several neuroendocrine gut hormones were negative. Serum NSE was elevated. This case represents a SCCOPT arising in an MCT in the right ovary with metastasis to the left one also containing a synchronous MCT. Surface implants and lymphovascular invasion suggested metastasis from the right ovarian SCCOPT and excluded a metastatic origin from usual locations of small cell carcinoma (SCC). SCCOPT is morphologically identical to SCC elsewhere, even sharing NSE serum elevation. Although the tumor was closely related to teratomatous mature tissues, a complex immunohistochemical panel failed to provide a tissue of origin.
一名37岁女性，双侧成熟囊性畸胎瘤（MCT）中发生的双侧肺型小细胞卵巢癌（SCCOPT），表现为ⅢB期。显微镜下，肿瘤巢与皮样隆起相关，表达全细胞角蛋白、EMA、CD56、嗜铬粒蛋白A、NSE、突触素和SOX2。SALL4也呈局灶性阳性。CDX2、TTF1、PAX8、CK7、CK20和几种神经内分泌肠道激素均为阴性。血清NSE升高。该病例代表右侧卵巢MCT中发生的SCCOPT转移至左侧卵巢，左侧卵巢也含有同步的MCT。表面种植和淋巴管侵犯提示右侧卵巢SCCOPT转移，排除了小细胞癌（SCC）常见部位的转移起源。SCCOPT在形态上与其他部位的SCC相同，甚至血清NSE也升高。尽管肿瘤与畸胎瘤成熟组织密切相关，但复杂的免疫组化结果未能确定其组织起源。
