Tazo Yuki, Yoshimura Yoshihiro, Shoda Takashi, Kyushima Noriyuki, Okada Takemichi, Yamazaki Hitoshi
Department of Gynecology and Obstetrics, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, Japan.
Department of Pathology, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, Japan.
J Med Case Rep. 2016 Jan 22;10:20. doi: 10.1186/s13256-015-0783-5.
Ovarian mature cystic teratoma (MCT) is a common neoplasm in women. While malignant transformation of MCT is relatively rare, squamous cell carcinoma is the most frequent malignant neoplasm arising from MCT. Some tumor markers have been reported to be useful for prediction of MCT malignant transformation prior to operation. However, widely accepted use of these markers remains to be established. In the present study, we report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels.
We present two cases of squamous cell carcinoma arising from ovarian MCT. The first case was a 45-year-old Asian woman referred to our hospital after her periodical company medical checkup, due to possible ovarian tumor. Image analysis suggested a dermoid cyst, and left salpingo-oophorectomy was performed. Because the cyst was histologically diagnosed as an invasive squamous cell carcinoma arising from an MCT, our patient underwent an additional preventative operation. The TNM classification and FIGO stage were T1aNXM0 and Ia, respectively. The second case was a 53 -year-old Asian woman who visited our hospital due to complaints of abdominal pain and urinary retention. Image analysis and laboratory data showing high serum levels of SCC antigen (normal range: < 1.5 ng/mL) and CA19-9 (normal range: < 37 U/mL), which strongly suggested malignant transformation of MCT. Frozen sections obtained during the operation were histologically analyzed to confirm malignancy, and our patient underwent an additional operation. The TNM classification and FIGO stage were T1aNXM0 and Ia, respectively.
We report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels.
卵巢成熟囊性畸胎瘤（MCT）是女性常见的肿瘤。虽然MCT的恶性转化相对罕见，但鳞状细胞癌是MCT最常见的恶性肿瘤。一些肿瘤标志物已被报道可用于术前预测MCT的恶性转化。然而，这些标志物的广泛应用仍有待确立。在本研究中，我们报告了术中冰冻切片评估以及术前肿瘤标志物水平测量的实用性。
我们报告两例由卵巢MCT引起的鳞状细胞癌病例。第一例是一名45岁的亚洲女性，在定期公司体检后因可能的卵巢肿瘤转诊至我院。影像分析提示为皮样囊肿，遂行左侧输卵管卵巢切除术。由于囊肿经组织学诊断为起源于MCT的浸润性鳞状细胞癌，我们的患者接受了额外的预防性手术。TNM分类和FIGO分期分别为T1aNXM0和Ia期。第二例是一名53岁的亚洲女性，因腹痛和尿潴留前来我院就诊。影像分析和实验室数据显示血清鳞状细胞癌抗原（SCC抗原）水平升高（正常范围：<1.5 ng/mL）和CA19-9水平升高（正常范围：<37 U/mL），强烈提示MCT发生了恶性转化。术中获取的冰冻切片经组织学分析以确认恶性肿瘤，我们的患者接受了额外的手术。TNM分类和FIGO分期分别为T1aNXM0和Ia期。
我们报告了术中冰冻切片评估以及术前肿瘤标志物水平测量的实用性。
