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双侧卵巢囊性畸胎瘤合并左侧支持-间质细胞瘤:一例报告。

Bilateral ovarian cystic teratomas with a left Sertoli Leydig cell tumor: A case report.

作者信息

Zhang Yingtong, Li Shimei, Luo Jie, Sun Ping, Song Yulan

机构信息

Department of Endocrinology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.

Department of Gynaecology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.

出版信息

Medicine (Baltimore). 2025 May 9;104(19):e42462. doi: 10.1097/MD.0000000000042462.

DOI:10.1097/MD.0000000000042462
PMID:40355173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12074108/
Abstract

RATIONALE

Ovarian mature cystic teratoma (MCT) is the most common ovarian germ cell tumor, and it is typically unilateral, although bilateral MCTs have been observed. Sertoli Leydig cell tumors (SLCTs) are rare ovarian tumors that can cause hyperandrogenemia. When patients have these 2 tumors at the same time, it is highly challenging to diagnose them.

PATIENT CONCERN

A 32-year-old female patient who complained of a pelvic mass for 1 year and amenorrhea for 6 months with high testosterone and 17-hydroxyprogesterone levels was suspected of having a malignant ovarian tumor. Transvaginal ultrasound revealed mixed lesions in the bilateral adnexal areas, and the nature of the left slightly hyperechoic mass was not determined.

DIAGNOSES

On the basis of the patient's laboratory examination, imaging examination and pathological examination, she was diagnosed with hyperandrogenemia and bilateral MCTs with a left SLCT.

INTERVENTIONS

The patient underwent laparoscopic surgery to remove bilateral ovarian neoplasms.

OUTCOMES

Testosterone levels decreased to 1.51 nmol/L on the 1st day after fertility-sparing bilateral ovarian tumor resection and to 0.73 nmol/L on the 5th day.

LESSONS

In conclusion, we reported a case of bilateral MCTs with left SLCT. The patient examinations supported the diagnosis of this rare disease. Once ovarian SLCT is diagnosed, the tumor should be surgically removed immediately, and the subsequent treatment plan should be selected according to the immunohistochemical results.

摘要

理论依据

卵巢成熟囊性畸胎瘤(MCT)是最常见的卵巢生殖细胞肿瘤,通常为单侧性,不过也有双侧MCT的病例报道。支持细胞-间质细胞瘤(SLCT)是罕见的卵巢肿瘤,可导致高雄激素血症。当患者同时患有这两种肿瘤时,诊断极具挑战性。

患者情况

一名32岁女性患者,主诉盆腔肿物1年,闭经6个月,睾酮和17-羟孕酮水平升高,怀疑患有卵巢恶性肿瘤。经阴道超声检查发现双侧附件区有混合性病变,左侧稍高回声肿物的性质未明确。

诊断

根据患者的实验室检查、影像学检查及病理检查结果,诊断为高雄激素血症、双侧MCT伴左侧SLCT。

干预措施

患者接受了腹腔镜手术切除双侧卵巢肿瘤。

结果

保留生育功能的双侧卵巢肿瘤切除术后第1天,睾酮水平降至1.51 nmol/L,第5天降至0.73 nmol/L。

经验教训

总之,我们报道了一例双侧MCT伴左侧SLCT的病例。患者的各项检查结果支持了对这种罕见疾病的诊断。一旦诊断为卵巢SLCT,应立即手术切除肿瘤,并根据免疫组化结果选择后续治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e9/12074108/6158a2087fae/medi-104-e42462-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e9/12074108/5f7c2ade6d3d/medi-104-e42462-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e9/12074108/6158a2087fae/medi-104-e42462-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e9/12074108/5f7c2ade6d3d/medi-104-e42462-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e9/12074108/6158a2087fae/medi-104-e42462-g002.jpg

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本文引用的文献

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Gynecol Endocrinol. 2023 Aug 9;39(1):2247098. doi: 10.1080/09513590.2023.2247098.
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Mature Cystic Teratoma: An Integrated Review.成熟囊性畸胎瘤:综合评价。
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Practical Approach to Hyperandrogenism in Women.女性高雄激素血症的实用诊疗方法
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Sertoli Leydig Cell Tumour Initially Misdiagnosed as Polycystic Ovarian Syndrome and Congenital Adrenal Hyperplasia: A Case Report.塞尔托利-莱迪希细胞瘤最初被误诊为多囊卵巢综合征和先天性肾上腺皮质增生症:一例报告。
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Ovarian tumors in children: how common are lesion recurrence and metachronous disease? A UK CCLG Surgeons Cancer Group nationwide study.儿童卵巢肿瘤:病变复发和异时性疾病的发生率有多高?一项英国 CCLG 外科医生癌症组的全国性研究。
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