Jia Nan, Chen Yan, Tao Xiang, Ou Enzhi, Lu Xin, Feng Weiwei
Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shen Yang Road, Shanghai, 200090, People's Republic of China.
Shanghai Key Laboratory of Female Reproductive Endocrine-Related Disease, Fudan University, 413 Zhao Zhou Road, Shanghai, 200011, People's Republic of China.
J Ovarian Res. 2017 Jul 20;10(1):46. doi: 10.1186/s13048-017-0334-3.
Choriocarcinoma of the ovary is rare. This tumor can arise from gestational tissue or pure germ cells of the ovary, the former results in gestational choriocarcinoma. The clinical characteristics and histology of both tumor types are identical, differentiation of these tumors is necessary for effective treatment. One strategy for the differentiation of these tumors types is to identify the presence of paternal DNA by DNA polymorphic analysis.
In the present case, a 27-year-old patient with a history of amenorrhea, lower abdominal pain and vaginal bleeding received a laparoscopic dissection of cystic mass of the right ovary according to an initial diagnosis of ectopic pregnancy. Primary choriocarcinoma of the ovary was diagnosed by pathology, but its origin was uncertain. DNA polymorphic analysis was then performed and a gestational origin was confirmed. The patient subsequently exhibited an excellent response to chemotherapy, achieved complete remission and gave birth to a healthy baby.
Differentiation between two etiologies of primary choriocarcinoma can be achieved with DNA polymorphic analysis and it is necessary to distinguish between them to approach to an appropriate treatment of a patient.
卵巢绒毛膜癌较为罕见。该肿瘤可起源于妊娠组织或卵巢的纯生殖细胞,前者导致妊娠性绒毛膜癌。这两种肿瘤类型的临床特征和组织学表现相同,区分这些肿瘤对于有效治疗至关重要。区分这些肿瘤类型的一种策略是通过DNA多态性分析来确定父源DNA的存在。
在本病例中,一名有闭经、下腹痛和阴道出血病史的27岁患者,最初被诊断为异位妊娠,接受了腹腔镜下右卵巢囊性肿物切除术。术后病理诊断为原发性卵巢绒毛膜癌,但其起源不明。随后进行了DNA多态性分析,证实为妊娠起源。该患者随后对化疗表现出良好反应,实现完全缓解,并产下一名健康婴儿。
通过DNA多态性分析可实现原发性绒毛膜癌两种病因的鉴别,区分它们对于为患者制定合适的治疗方案很有必要。