Karlen J R, Akbari A, Cook W A
Obstet Gynecol. 1979 Mar;53(3):330-5.
From a review of 26 reported case (our case being the 27th) of dysgerminoma associated with pregnancy, several salient facts are evident. Torsion and incarceration are common among these rapidly enlarging tumors. Obstetrical complications occurred in nearly half and fetal demise in one quarter of the reviewed cases. Our case was typical of patients presenting with this vexed problems: The patient was under 25 (as were 70%); nulliparous (as were 67%); and the tumor appeared confined to one ovary (as in 89%). Authorities are in dispute as to the treatment of stage IA dysgerminomas, and the association of pregnancy complicates this debate even further. The results of conservative treatment in this series were jarring: There were recurrences in 30% of the 23 stage IA tumors, and the recurrences were all following unilateral oophorectomy. In our case, the grossly normal contralateral ovary was infiltrated with dysgerminoma cells. While treatment of a young woman with a dysgerminoma of 1 ovary is a matter of perplexity, we believe that a unilateral operation should be limited to those women who desire above all earthly things to retain their childbearing capacity.
回顾26例（我们的病例为第27例）妊娠合并无性细胞瘤的报道后，一些显著事实显而易见。在这些迅速增大的肿瘤中，扭转和嵌顿很常见。近一半病例出现产科并发症，四分之一的病例出现胎儿死亡。我们的病例是这类棘手问题患者的典型代表：患者年龄在25岁以下（70%的患者如此）；未生育（67%的患者如此）；肿瘤似乎局限于一侧卵巢（89%的病例如此）。对于IA期无性细胞瘤的治疗，权威们存在争议，而妊娠的合并使这场争论更加复杂。该系列保守治疗的结果令人震惊：23例IA期肿瘤中有30%复发，且复发均发生在单侧卵巢切除术后。在我们的病例中，肉眼看似正常的对侧卵巢被无性细胞瘤细胞浸润。虽然治疗单侧卵巢无性细胞瘤的年轻女性是个难题，但我们认为，单侧手术应仅限于那些最渴望保留生育能力的女性。
