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成熟性卵巢囊性畸胎瘤恶变:病例系列。

Malignant transformation arising from mature ovarian cystic teratoma: A case series.

机构信息

Department of Obstetrics and Gynecology, The Central Hospital of Enshi Autonomous Prefecture.

Department of Oncology, Lichuan People's Hospital.

出版信息

Medicine (Baltimore). 2021 Apr 2;100(13):e24726. doi: 10.1097/MD.0000000000024726.

Abstract

Malignant transformation arising in mature cystic teratoma (MT-MCT) is a rare neoplasm of the ovary. Herein, we aimed to evaluate the clinicopathological features and treatment outcome of the Han Chinese women with MT-MCT.In this retrospective study, the clinical data of patients who had been surgically treated from January 2000 to November 2019 and in whom the diagnosis of MCT was confirmed based on the pathology were included. Fourteen patients with MT-MCT from a total of 569 cases (2.46% incidence) of MCT were reviewed.The mean age of patients with MT-MCT was 51.3 (range, 31-71) years, while the mean age of patients with MCT was 45.3 (range, 17-62) years. Upon gross examination, the mean size of MT-MCT was 14.0 (range, 11-25) cm, whereas the mean size of MCT was 7.5 (range, 4-10) cm. Primary surgical staging was performed in all cases. Complete cytoreduction and suboptimal surgical resection were performed in 12 (85.7%) and 2 (14.3%) cases, respectively. Thirteen patients with malignant transformation of squamous cell carcinoma (SCC) whose Federation International of Gynecology and Obstetrics stage was >1 received chemotherapy, comprising carboplatin and paclitaxel. Response to the chemotherapy regimen was complete in 12 patients; 1/12 patients died within the median follow-up period of 16.5 months. The 5-year overall survival rate and disease-free survival rates were 31.2% and 31.6%, respectively.From the data generated, we conclude that the rate of MT-MCT increases with age. The MT-MCT was much higher in women of postmenopausal age than in younger women. We described our experience of successfully treating patients with malignant transformation of SCC with primary surgical staging and adjuvant chemotherapy (cisplatin, paclitaxel, bleomycin, and etoposide) that might improve survival in patients with advanced-stage disease.

摘要

成熟囊性畸胎瘤(MCT)恶变(MT-MCT)是一种罕见的卵巢肿瘤。本研究旨在评估汉族女性 MT-MCT 的临床病理特征和治疗结果。

本回顾性研究纳入了 2000 年 1 月至 2019 年 11 月期间因手术治疗且病理证实为 MCT 的患者。共纳入 569 例 MCT 患者,其中 14 例(2.46%)为 MT-MCT。MT-MCT 患者的平均年龄为 51.3(31-71)岁,MCT 患者的平均年龄为 45.3(17-62)岁。大体检查显示,MT-MCT 的平均大小为 14.0(11-25)cm,MCT 的平均大小为 7.5(4-10)cm。所有患者均进行了初始的外科分期。完全肿瘤细胞减灭术和非满意的肿瘤细胞减灭术分别在 12 例(85.7%)和 2 例(14.3%)患者中进行。13 例恶性转化为鳞状细胞癌(SCC)的患者,FIGO 分期>1,接受了卡铂和紫杉醇化疗。12 例患者对化疗方案有完全缓解,12 例患者中有 1 例在中位随访期 16.5 个月内死亡。5 年总生存率和无病生存率分别为 31.2%和 31.6%。

研究结果表明,MT-MCT 的发生率随年龄增长而增加。绝经后女性 MT-MCT 的发生率明显高于年轻女性。本研究描述了我们成功治疗 SCC 恶性转化患者的经验,采用初始外科分期和辅助化疗(顺铂、紫杉醇、博来霉素和依托泊苷),可能改善晚期疾病患者的生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75f4/8021333/544806cd6a27/medi-100-e24726-g001.jpg

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