Ikai Nobuyasu, Sato Hidetaka, Yamada Yoko, Moritani Suzuko, Obikane Hiyo
Department of Diagnostic Pathology, Tokyo Metropolitan Police Hospital, Tokyo, JPN.
Department of Obstetrics and Gynecology, Tokyo Metropolitan Police Hospital, Tokyo, JPN.
Cureus. 2025 Jul 9;17(7):e87629. doi: 10.7759/cureus.87629. eCollection 2025 Jul.
Malignant transformation of an ovarian mature teratoma is a rare phenomenon. The most common malignant tumor is squamous cell carcinoma, followed by other histologic subtypes. Carcinosarcoma in ovarian mature teratoma is much less common, with only several case reports in the literature, and their autopsies have been rarely reported. Here we report a rare autopsy-documented case of ovarian mature teratoma, which has both squamous cell carcinoma and sarcomatous components. The right adnexectomy specimen of a 45-year-old female patient contained non-invasive (in situ) and invasive squamous cell carcinoma and spindle cell sarcoma, which were juxtaposed with transitions between the two, epithelial (carcinomatous) and mesenchymal (sarcomatous), components. The patient died seven weeks after surgery, and an autopsy was performed, revealing significant peritoneal dissemination. For the intraperitoneal dissemination, all were histologically spindle cell sarcoma components, and no squamous cell carcinoma components were identified, suggesting that sarcomatous overgrowth occurred. Sarcomatous components also metastasized to the lung. Death was attributed to peritoneal dissemination of the sarcomatous component. In this case, extensive tissue sampling was performed both in the adnexectomy specimen and the autopsy specimen to conclude that sarcomatous overgrowth in carcinosarcoma is the cause of death.
卵巢成熟畸胎瘤的恶性转化是一种罕见现象。最常见的恶性肿瘤是鳞状细胞癌，其次是其他组织学亚型。卵巢成熟畸胎瘤中的癌肉瘤则更为少见，文献中仅有几例病例报告，且很少有尸检报道。在此，我们报告一例罕见的经尸检证实的卵巢成熟畸胎瘤病例，其同时具有鳞状细胞癌和肉瘤成分。一名45岁女性患者的右侧附件切除术标本包含非侵袭性（原位）和侵袭性鳞状细胞癌以及梭形细胞肉瘤，两者并存且存在上皮（癌性）和间充质（肉瘤性）成分之间的过渡区域。患者术后七周死亡，进行了尸检，发现有明显的腹膜播散。对于腹膜播散，所有组织学检查均为梭形细胞肉瘤成分，未发现鳞状细胞癌成分，提示发生了肉瘤过度生长。肉瘤成分也转移至肺部。死亡原因是肉瘤成分的腹膜播散。在该病例中，对附件切除术标本和尸检标本均进行了广泛的组织取样，以得出癌肉瘤中肉瘤过度生长是死亡原因的结论。
