Khachatryan A
Yerevan State Medical University after M. Heratsi, Department of Pathological Anatomy and Clinial Morphology, Armenia.
Georgian Med News. 2016 Nov(Issue):22-28.
Extremely rare ovarian primary tumors formed in a mature cystic teratomaare described in the literature. This research work studies the frequency of malignant mature cystic teratoma, as well as their clinical and morphological features and necessity of intraoperative histological examination of all teratomas. Cases histories of 56 patients, suffering from ovarian mature cystic teratomahave been studied in MC Shengavit in the period of 2003 - 2015. Among them 4 patients with the somatic malignancies were identified. Morphological methods, which are considered to be "gold standard" of tumor investigation, were used in staining the slides with hematoxylin - eosin. According to the literature the secondary malignant transformation rarely occurs and is typical in postmenopausal women, with a frequency of 0.17-3%. According to the results of our study, malignant tumors in mature cystic teratomas were observed in 4 (7,14%) from the total number of mature cystic teratomas (n=56). There was not revealed a correlation between the duration of the complaints, age of the patients, sizes of ovarian mature teratoma and malignization degree. Thus, the greatest difficulties of clinical diagnosis of malignant tumors in the ovarian mature cystic teratomas were in the early stage of the disease, because of a variety of clinical manifestations, not pathognomonic for malignization. All mentioned symptoms may be observed in the patients with usual mature cystic teratomas. Тhis cases confirm the necessity to take tissue samples from the other ovary for intraoperative histopathological evaluation in each case of mature cystic teratomas. It is necessary to examine a large number of tumor sites, to prevent errors in the assessment of the maturity degree of teratoma.
文献中描述了在成熟囊性畸胎瘤中形成的极其罕见的卵巢原发性肿瘤。本研究工作探讨了恶性成熟囊性畸胎瘤的发生率、临床和形态学特征以及对所有畸胎瘤进行术中组织学检查的必要性。对2003年至2015年期间在圣加维特医疗中心就诊的56例患有卵巢成熟囊性畸胎瘤的患者病历进行了研究。其中有4例患者被确诊为伴有躯体恶性肿瘤。形态学方法被认为是肿瘤研究的“金标准”,用于苏木精-伊红染色切片。据文献报道,继发性恶性转化很少发生,在绝经后女性中较为典型,发生率为0.17%-3%。根据我们的研究结果,在成熟囊性畸胎瘤总数(n=56)中,有4例(7.14%)观察到恶性肿瘤。未发现主诉持续时间、患者年龄、卵巢成熟畸胎瘤大小与恶性程度之间存在相关性。因此,卵巢成熟囊性畸胎瘤恶性肿瘤临床诊断的最大困难在于疾病早期,因为其临床表现多样,并非恶性病变所特有。所有上述症状在普通成熟囊性畸胎瘤患者中也可能出现。这些病例证实了在每例成熟囊性畸胎瘤手术中从对侧卵巢获取组织样本进行术中组织病理学评估的必要性。有必要检查大量肿瘤部位,以防止在评估畸胎瘤成熟度时出现错误。