Department of Pathology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan.
Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Yufu-shi, Oita, 879-5593, Japan.
Diagn Pathol. 2019 Nov 4;14(1):122. doi: 10.1186/s13000-019-0890-5.
Teratocarcinosarcoma (TCS) is a rare aggressive tumor of the nasal cavity and paranasal sinuses and has both epithelial and two or more mesenchymal components. In other organs, 5 cases of ovarian tumors closely resembling TCS have been reported; however, there has been no published case of cervical TCS. Herein, we describe a unique case of cervical tumor that had carcinosarcomatous and teratomatous features, resembling a sinonasal TCS.
A 45-year-old woman presented to our hospital for evaluation of a cervical lesion. The gynecologist found a large polypoid mass, whose biopsy showed glandular components of probable germ cell origin based on the immunohistochemical features. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy. The cervical polypoid mass was found to consist of both epithelial and mesenchymal tissues, including immature glandular structure resembling fetal enteric tubules, neuroepithelial cells, hyaline cartilage, and rhabdomyosarcoma cells. This tumor was diagnosed as TCS of the uterine cervix. Following the surgery, the patient received radiotherapy and has been free of disease for 13 months.
This is the first case report of cervical TCS. The tumor is thought to be histogenetically less associated with HPV infection, and its teratomatous components with an absence of cytogenetic abnormalities (including isochromosome 12p (i(12p)) suggest a analogous histogenesis compared to pure mature or immature teratoma.
畸胎癌肉瘤（TCS）是一种罕见的鼻腔和鼻窦侵袭性肿瘤，具有上皮和两种或更多间充质成分。在其他器官中，已有 5 例卵巢肿瘤与 TCS 非常相似的报道；然而，尚未有宫颈 TCS 的报道。在此，我们描述了 1 例具有癌肉瘤和畸胎瘤特征的宫颈肿瘤，类似于鼻腔鼻窦 TCS。
一名 45 岁女性因宫颈病变就诊于我院。妇科医生发现了一个大的息肉状肿块，根据免疫组化特征，活检显示可能来源于生殖细胞的腺体成分。患者接受了全子宫切除术和双侧输卵管卵巢切除术。宫颈息肉状肿块由上皮和间充质组织组成，包括类似于胎儿肠管的未成熟腺体结构、神经上皮细胞、透明软骨和横纹肌肉瘤细胞。该肿瘤诊断为宫颈 TCS。手术后，患者接受了放疗，目前已无病生存 13 个月。
这是首例宫颈 TCS 的报道。该肿瘤的发生与 HPV 感染的相关性较低，其畸胎瘤成分无细胞遗传学异常（包括 12p 等臂染色体缺失（i(12p)），与单纯成熟或未成熟畸胎瘤相比，其组织发生相似。
