Liu Jie
Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China.
World J Clin Cases. 2022 Jul 16;10(20):7076-7081. doi: 10.12998/wjcc.v10.i20.7076.
Mature teratoma is a common benign ovarian germ cell tumor, accounting for about 20% of ovarian tumors. The malignant transformation of this tumor is less than 2%. The most common type is squamous cell carcinoma, followed by adenocarcinoma. Malignant transformation of colonic mature teratoma is extremely rare. We here report a case of malignant transformation of primary mature teratoma of the colon. The type of malignant transformation was adenocarcinoma.
A 63-year-old woman was admitted to our hospital due to persistent pain in her right lower abdomen for 1 mo, and she had no nausea, vomiting, blood in the stools, or other symptoms. Preoperative colonoscopy showed uplift of the sigmoid colon mucosa and submucosa. The biopsy showed squamous epithelium. However, contrast-enhanced computed tomography of abdomen and pelvis showed a localized thickening of the sigmoid wall, suggesting colon cancer. Endoscopic ultrasonography (EUS) revealed that the structure of the intestinal wall at the base of the lesion was destroyed, and the boundary between the lesion and the surroundings was unclear. According to the findings of the EUS, the patient did not undergo endoscopic submucosal dissection, but underwent radical resection of the tumor. Histologically, squamous epithelium was seen on the mucosal surface of the colon wall, cartilage and glands were seen under the epithelium, and adenocarcinoma was seen on the muscular layer and serous surface. The final pathological diagnosis was malignant teratoma of the colon. We have followed up the patient for 2 mo since the operation, and the patient recovered well.
This case suggests the possibility of mature teratoma in the colon and recognition of malignant types, and it should not be considered as an exclusively ovarian tumor.
成熟畸胎瘤是一种常见的卵巢良性生殖细胞肿瘤,约占卵巢肿瘤的20%。该肿瘤的恶变率低于2%。最常见的类型是鳞状细胞癌,其次是腺癌。结肠成熟畸胎瘤恶变极为罕见。我们在此报告一例结肠原发性成熟畸胎瘤恶变病例。恶变类型为腺癌。
一名63岁女性因右下腹部持续疼痛1个月入院,无恶心、呕吐、便血等其他症状。术前结肠镜检查显示乙状结肠黏膜和黏膜下层隆起。活检显示为鳞状上皮。然而,腹部和盆腔增强计算机断层扫描显示乙状结肠壁局限性增厚,提示结肠癌。内镜超声检查(EUS)显示病变底部肠壁结构破坏,病变与周围边界不清。根据EUS检查结果,患者未行内镜黏膜下剥离术,而是接受了肿瘤根治性切除术。组织学检查显示,结肠壁黏膜表面可见鳞状上皮,上皮下可见软骨和腺体,肌层和浆膜面可见腺癌。最终病理诊断为结肠恶性畸胎瘤。自手术以来,我们对患者进行了2个月的随访,患者恢复良好。
该病例提示结肠存在成熟畸胎瘤及恶变类型的可能性,不应将其仅视为卵巢肿瘤。