Department of Oncology, Second Affiliated Hospital of Army Military Medical University, Chongqing, China.
Department of Pathology, Second Affiliated Hospital of Army Military Medical University, Chongqing, China.
Ann Palliat Med. 2021 Jul;10(7):8499-8505. doi: 10.21037/apm-20-2429. Epub 2021 Jun 21.
Mature cystic teratomas (MCTs), also known as dermoid cysts, are the most common ovarian germ cell tumors and the most common ovarian neoplasms in patients younger than 20 years. MCTs mainly appear as pelvic masses that are made up of different types of well differentiated derivates of at least two germinative cell types. MCT of the ovary is always benign lesions with slow growth and good prognosis. Unfortunately, in about 1-2% of cases, it may undergo malignant transformation. At present, surgical treatment is the preferred option for the early stage of malignant transformation of teratomas, while with a high postoperative recurrence rate. For advanced or recurrent malignant ovarian teratomas, the effect of conventional chemotherapy or radiotherapy is poor, leading to high mortality. Thus, identifying novel treatment for malignant transformed MCTs is an urgently need in clinic. Recently, PD-1 antibody-based immunotherapy has achieved great success in treatment of lung cancer, melanoma, and other malignant tumors. However, its effect on the malignant transformation of ovarian teratomas has not yet been reported. Here we reported a patient who suffered malignant transformation of ovarian teratoma and responded well to camrelizumab, an anti-PD-1 inhibitor.
成熟囊性畸胎瘤（MCT），又称皮样囊肿，是最常见的卵巢生殖细胞肿瘤，也是 20 岁以下患者最常见的卵巢肿瘤。MCT 主要表现为盆腔肿块，由至少两种生殖细胞类型的不同类型的高度分化衍生物组成。卵巢 MCT 始终为良性病变，生长缓慢，预后良好。不幸的是，约 1-2%的病例可能发生恶性转化。目前，手术治疗是畸胎瘤恶性转化早期的首选方法，但其术后复发率较高。对于晚期或复发性恶性卵巢畸胎瘤，常规化疗或放疗效果差，导致死亡率高。因此，寻找治疗恶性转化 MCT 的新方法在临床上是迫切需要的。最近，PD-1 抗体免疫疗法在治疗肺癌、黑色素瘤等恶性肿瘤方面取得了巨大成功。然而，其对卵巢畸胎瘤恶性转化的疗效尚未见报道。本文报道了一例卵巢畸胎瘤恶性转化患者，对 PD-1 抑制剂卡瑞利珠单抗反应良好。
