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卵巢癌肉瘤:一例报告并文献复习

Carcinosarcoma of the ovary: a case report and literature review.

作者信息

Zheng Jian, Tang Cui, Liu Ping, Hao Hua

机构信息

Department of Pathology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.

Department of Radiology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

Front Oncol. 2023 Oct 18;13:1278300. doi: 10.3389/fonc.2023.1278300. eCollection 2023.

Abstract

OBJECTIVE

Carcinosarcoma of the ovary is a rare pathological type of ovarian cancer that is highly aggressive and occurs most frequently in the female reproductive tract at the site of the uterus. Herein, we explore the clinicopathological features, diagnosis, differential diagnosis, and treatment options for carcinosarcoma of the ovary.

METHODS

We analyzed the clinical data of a case of carcinosarcoma, observed its histological morphology and immunohistochemical characteristics, detected the homologous recombination repair deficiency gene mutation, and reviewed the relevant literature.

RESULTS

A 76-year-old menopausal woman visited our hospital because of abdominal distension, difficulty in urination, and constipation. Ultrasonography demonstrated abnormalities in the uterus and pelvic cavity, suggesting that the patient should undergo surgery. Immunohistochemical findings of carcinosarcoma of the right ovary were as follows: CK fraction (+), vimentin fraction (+), CK5/6 foci (+), p16 (+), p53 in approximately 70% (+), WT-1 foci (+), ER foci (+), PR part (+), Her-2 (1+), CK7 fraction (+), CK20 foci (+), CD99 fraction (+), CD10 fraction (+), CD56 foci (+), c-kit foci (+), SMA part (+), desmin foci (+), PD-L1 (-), SALL4 (-), OCT3/4 (-), p63 (-), p40 (-), D2-40 (-), inhibin (-), PLAP (-), CD30 (-), and Ki67 hotspot in approximately 80% (+). The patient underwent tumor cytoreduction and adjuvant chemotherapy. Currently, she is being followed up for 16 months and has a good general condition.

CONCLUSION

The diagnosis of carcinosarcoma relies on histopathological examination and differentiation of carcinosarcoma from immature teratoma. The current therapeutic regimen for carcinosarcoma is still based on tumor cytoreduction and platinum-containing chemotherapy; research on targeted therapy is still in progress.

摘要

目的

卵巢癌肉瘤是一种罕见的卵巢癌病理类型,侵袭性强,最常发生于女性生殖道的子宫部位。在此,我们探讨卵巢癌肉瘤的临床病理特征、诊断、鉴别诊断及治疗方案。

方法

我们分析了1例癌肉瘤患者的临床资料,观察其组织形态学和免疫组化特征,检测同源重组修复缺陷基因突变,并复习相关文献。

结果

一名76岁绝经后女性因腹胀、排尿困难和便秘前来我院就诊。超声检查显示子宫和盆腔异常,提示患者应接受手术。右卵巢癌肉瘤的免疫组化结果如下:细胞角蛋白(CK)成分(+),波形蛋白成分(+),CK5/6灶性(+),p16(+),p53约70%(+),WT-1灶性(+),雌激素受体(ER)灶性(+),孕激素受体(PR)部分(+),人表皮生长因子受体2(Her-2)(1+),CK7成分(+),CK20灶性(+),CD99成分(+),CD10成分(+),CD56灶性(+),c-kit灶性(+),平滑肌肌动蛋白(SMA)部分(+),结蛋白灶性(+),程序性死亡配体1(PD-L1)(-),SALL4(-),八聚体结合转录因子3/4(OCT3/4)(-),p63(-),p40(-),D2-40(-),抑制素(-),胎盘碱性磷酸酶(PLAP)(-),CD30(-),Ki67热点约80%(+)。患者接受了肿瘤细胞减灭术和辅助化疗。目前,她正在接受16个月的随访,总体状况良好。

结论

癌肉瘤的诊断依赖于组织病理学检查以及癌肉瘤与未成熟畸胎瘤的鉴别。目前癌肉瘤的治疗方案仍以肿瘤细胞减灭术和含铂化疗为主;靶向治疗的研究仍在进行中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cea/10618416/9362f0066d29/fonc-13-1278300-g001.jpg

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