Nagayama Akiho, Miyagawa Chiho, Kashima Yoko, Ohta Mamiko, Otani Tomoyuki, Kurosaki Takashi, Isomoto Kohsuke, Inagaki Chiaki, Takahama Takayuki, Yonesaka Kimio, Hayashi Hidetoshi, Sakai Kazuko, Nishio Kazuto, Nakagawa Kazuhiko, Matsumura Noriomi
Department of Obstetrics and Gynecology, Chibune General Hospital, 3-2-39 Fukumachi, Nishiyodogawa- Ku, Osaka, 555-0034 Japan.
Department of Obstetrics and Gynecology, Kindai University, 377-2 Ohnohigashi, Osaka-Sayama, Osaka, 589-8511 Japan.
Int Cancer Conf J. 2024 Dec 19;14(2):85-90. doi: 10.1007/s13691-024-00740-z. eCollection 2025 Apr.
A 69-year-old multiparous postmenopausal woman had undergone bilateral total hip arthroplasty 17 years ago. Computed tomography showed a mature teratoma of 10 cm in the pelvis. Subsequently, she presented with symptoms of hoarseness and weight loss, along with evidence of malignant transformation of the same tumor in the pelvis and multiple enlarged lymph nodes. Bilateral adnexectomy was performed via laparotomy, yet peritoneal dissemination persisted. The ovarian tumor's histopathological diagnosis was mature teratoma with squamous cell carcinoma. Additionally, the mediastinal lymph nodes biopsy revealed poorly differentiated carcinoma. Comprehensive genomic profiling testing of the ovarian tumor showed pathogenic variants of and , a high tumor mutational burden, homologous recombination deficiency and the absence of human papilloma virus. The similar genomic testing of the mediastinal tumor revealed three variants of uncertain significance that were common to the ovarian tumor. However, no variants of or were identified. Following surgery, she demonstrated a partial response to six cycles of conventional paclitaxel and carboplatin. She then received maintenance treatment with niraparib; however, disease progression subsequently occurred. The patient was treated with pembrolizumab and is currently receiving treatment with a partial response. Previous reports have demonstrated the efficacy of immune checkpoint inhibitors in 5 out of 6 cases of malignant transformation of mature teratomas, and this treatment appears to be a promising strategy.
The online version contains supplementary material available at 10.1007/s13691-024-00740-z.
一名69岁多产绝经后女性17年前接受了双侧全髋关节置换术。计算机断层扫描显示盆腔有一个10厘米的成熟畸胎瘤。随后，她出现声音嘶哑和体重减轻的症状，同时盆腔内同一肿瘤发生恶性转化并有多个肿大淋巴结。通过剖腹手术进行了双侧附件切除术，但腹膜播散仍持续存在。卵巢肿瘤的组织病理学诊断为成熟畸胎瘤伴鳞状细胞癌。此外，纵隔淋巴结活检显示为低分化癌。卵巢肿瘤的综合基因组分析检测显示有 和 的致病变体、高肿瘤突变负荷、同源重组缺陷且无人乳头瘤病毒。纵隔肿瘤的类似基因组检测显示有三个意义未明的变体与卵巢肿瘤相同。然而，未发现 或 的变体。手术后，她对六个周期的传统紫杉醇和卡铂治疗有部分反应。然后她接受了尼拉帕利维持治疗；然而，随后疾病进展。该患者接受了帕博利珠单抗治疗，目前正在接受治疗且有部分反应。既往报告显示免疫检查点抑制剂在6例成熟畸胎瘤恶性转化病例中有5例有效，这种治疗似乎是一种有前景的策略。
在线版本包含可在10.1007/s13691-024-00740-z获取的补充材料。
