Shanmugasundaram Gouthaman, Sundaramoorthy Elilnambi, Sudalaiandi Suresh, Kondaveeti Satish Srinivas, Johnson Thanka, Swaminathan Rajendiran, Ramesh Anita
Department of Surgical Oncology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, India.
Department of Medical Oncology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, India.
World J Oncol. 2015 Aug;6(4):421-425. doi: 10.14740/wjon848w. Epub 2015 Aug 27.
Surface epithelial stromal tumors account for approximately 60% of all ovarian tumors and approximately 90% of all ovarian malignancies. Sex cord stromal tumors account for 7% of all malignant ovarian tumors. Germ cell tumors make up only 3-7% of malignant ovarian tumors. A combination of serous carcinoma of the ovary and choriocarcinoma is rare. Until today such combination has been documented only in six cases in the English literature. Here, we describe a case of ovarian serous carcinoma, where histopathology revealed a combination of serous carcinoma with adjacent choriocarcinoma component in the extraovarian peritoneal deposits. A 64-year-old post-menopausal female was diagnosed to have stage IV ovarian cancer. She received six cycles chemotherapy. Subsequently she underwent optimal cytoreductive surgery. Microscopically, monomorphic histology (serous carcinoma) was noted in both the ovaries and dimorphic histologies (serous carcinoma and choriocarcinoma) in the sigmoid mesocolon nodule, omentum and left subdiaphragmatic nodules. Metronomic chemotherapy continued and patient is on regular follow-up for the past 1 year with stable disease. Recognition of choriocarcinomatous components in ovarian carcinomas is important because of its association with aggressive behavior. In spite of the aggressive histology, the patient is surviving for the past 1 year. Different chemotherapeutic regimens have been used in cases of mixed choriocarcinoma and carcinoma, but established chemotherapeutic regimens have not been described. Chemotherapeutic regimens that target both components have been advocated and used. The absence of choriocarcinoma in ovarian primary and its presence in the extraovarian peritoneal deposits have not been described in the English literature so far. This case is being presented for its rarity.
表面上皮间质肿瘤约占所有卵巢肿瘤的60%，约占所有卵巢恶性肿瘤的90%。性索间质肿瘤占所有卵巢恶性肿瘤的7%。生殖细胞肿瘤仅占卵巢恶性肿瘤的3%-7%。卵巢浆液性癌与绒毛膜癌的组合很罕见。迄今为止，英文文献中仅记录了6例这种组合的病例。在此，我们描述一例卵巢浆液性癌病例，其组织病理学显示在卵巢外腹膜种植灶中浆液性癌与相邻的绒毛膜癌成分并存。一名64岁绝经后女性被诊断为IV期卵巢癌。她接受了六个周期的化疗。随后她接受了最佳的细胞减灭术。显微镜下，双侧卵巢均可见单形性组织学（浆液性癌），乙状结肠系膜结节、大网膜和左膈下结节可见双形性组织学（浆液性癌和绒毛膜癌）。持续进行节拍化疗，患者在过去1年定期随访，病情稳定。认识到卵巢癌中的绒毛膜癌成分很重要，因为它与侵袭性行为有关。尽管组织学表现具有侵袭性，但患者在过去1年中一直存活。在绒毛膜癌与癌混合的病例中使用了不同的化疗方案，但尚未描述既定的化疗方案。有人主张并使用针对两种成分的化疗方案。卵巢原发灶中无绒毛膜癌而在卵巢外腹膜种植灶中存在绒毛膜癌的情况，迄今为止英文文献中尚未见描述。本病例因其罕见性而被呈现。
