Department of Pathology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Obstetrical Department, Lianyungang Maternal and Child Health Hospital, Lianyungang, China.
J Clin Lab Anal. 2022 May;36(5):e24364. doi: 10.1002/jcla.24364. Epub 2022 Mar 29.
Teratoma with nephroblastoma (TWN) is an extremely rare condition. Since 1984, only 45 reported cases have been identified. To our knowledge, there have been only two cases of TWN of ovarian origin.
We described a case of ovarian TWN who presented to us with painless abdominal masses 6 months after undergoing right ovarian cystectomy. The tumor had spread to the abdomen due to spontaneous rupture of the ovarian cyst and failure to undergo chemotherapy. Microscopically, the ovarian mass exhibited the typical components of a mature cystic teratoma. The tumors found in both the ovary and abdomen contained the nephroblastoma components and were strongly positive for WT-1. The patient was advised to undergo chemotherapy and she was lost to follow-up.
A careful histological examination is necessary for an accurate diagnosis, which is based on morphology and extensive immunohistochemical studies. According to the literature, surgical excision alone seems reasonable as the prognosis of TWN is considered to be good. However, due to the spontaneous rupture of the ovarian cyst, chemotherapy of the patient after the first surgery was necessary in our case. Therefore, additional case studies are needed to clarify the standardized treatment of TWN.
畸胎瘤合并肾母细胞瘤（TWN）是一种极其罕见的情况。自 1984 年以来，仅确认了 45 例报告病例。据我们所知，仅有两例卵巢起源的 TWN 病例。
我们描述了一例卵巢 TWN 患者，她在右侧卵巢囊肿切除术后 6 个月因无痛性腹部肿块就诊。由于卵巢囊肿自发破裂和未接受化疗，肿瘤已扩散至腹部。显微镜下，卵巢肿块表现出成熟囊性畸胎瘤的典型成分。在卵巢和腹部发现的肿瘤均含有肾母细胞瘤成分，并对 WT-1 呈强阳性。建议患者接受化疗，但她失访。
准确的诊断需要仔细的组织学检查，其依据是形态学和广泛的免疫组织化学研究。根据文献，单独进行手术切除似乎是合理的，因为 TWN 的预后被认为是良好的。然而，由于卵巢囊肿的自发破裂，我们的病例中患者在第一次手术后需要进行化疗。因此，需要进一步的病例研究来阐明 TWN 的标准化治疗。
