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实性假乳头状肿瘤:一例原发性卵巢起源病例报告及文献复习

Solid pseudopapillary neoplasm: Report of a case of primary ovarian origin and review of the literature.

作者信息

Liu An-Hao, Zhao Zi-Qing, Li Xiu-Wen, Xu Bin, Yu Run-Fang, Ye Shao-Fen, Miao Zhi-Hui, Huang Li-Li, Gao Bin-Bin, Lai Hai-Yan, Lin Jia-Hui, Ye Ming-Zhu, Huang Xiu-Min, Liu Zheng-Jin, Chen Xun

机构信息

Department of Obstetrics and Gynecology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

Department of Pathology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

出版信息

Heliyon. 2023 Aug 19;9(8):e19318. doi: 10.1016/j.heliyon.2023.e19318. eCollection 2023 Aug.

Abstract

BACKGROUND

Solid pseudopapillary neoplasms (SPNs) are uncommon tumors of low malignancy with a generally favorable prognosis, mostly originating from the pancreas. To date, 12 cases of SPNs with a primary ovarian origin (SPN-Os) have been reported globally, and their detailed characteristics have not been fully elucidated.

CASE DESCRIPTION

We reported the 13th SPN-O case, which occurred in a 52-year-old woman with an 18.5 cm left ovarian mass. Four imaging methods, including ultrasound, computed tomography, magnetic resonance imaging and positron emission tomography, were utilized before surgery. An elevated level of serum cancer antigen 125 was detected and a total hysterectomy plus bilateral salpingo-oophorectomy was performed. Microscopic examination revealed a typical solid pseudopapillary structure. The tumor cells were stained focally for pan-cytokeratin, synaptophysin, CD99 and CD10, while β-catenin, vimentin and CD56 were diffusely expressed. The Ki-67 proliferation index was 3%, and immunohistochemical (IHC) staining for chromogranin-A, inhibin-a, and E-cadherin was negative. No evidence of recurrence or metastasis was observed by clinical and imaging data during a 5-month postoperative follow-up.

CONCLUSION

This is a report of an unusual case of a primary ovarian SPN with an up-to-date review of SPN-Os. A minimum combination of imaging methods and IHC stains was proposed for SPN-Os, which may prove beneficial in clinical practice.

摘要

背景

实性假乳头状肿瘤(SPNs)是一种罕见的低恶性肿瘤,预后通常良好,大多起源于胰腺。迄今为止,全球已报道12例原发性卵巢实性假乳头状肿瘤(SPN-Os),其详细特征尚未完全阐明。

病例描述

我们报告了第13例SPN-O病例,发生在一名52岁女性身上,左侧卵巢有一个18.5 cm的肿块。术前采用了四种成像方法,包括超声、计算机断层扫描、磁共振成像和正电子发射断层扫描。检测到血清癌抗原125水平升高,遂行全子宫切除术加双侧输卵管卵巢切除术。显微镜检查显示典型的实性假乳头状结构。肿瘤细胞局灶性表达全细胞角蛋白、突触素、CD99和CD10,而β-连环蛋白、波形蛋白和CD56呈弥漫性表达。Ki-67增殖指数为3%,嗜铬粒蛋白A、抑制素-a和E-钙黏蛋白的免疫组织化学(IHC)染色均为阴性。术后5个月的临床和影像学资料未发现复发或转移迹象。

结论

本文报告了一例原发性卵巢SPN的罕见病例,并对SPN-Os进行了最新综述。提出了用于SPN-Os的最低限度成像方法和IHC染色组合,这在临床实践中可能是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ba2/10469959/dd4735c66843/gr1.jpg

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