Ellis J R, Elg S A
Tripler Army Medical Center, Tripler AMC, Hawaii 96859-5000, USA.
Hawaii Med J. 1995 Aug;54(8):704-5, 707.
Benign cystic teratoma is a very common ovarian lesion; and it commonly occurs during a woman's reproductive years and most often is benign. In approximately 1% to 2% of cases, however, it can undergo a malignant transformation with a very poor prognosis. This is especially the case when disseminated disease is present. Usually the associated malignancy is squamous cell carcinoma, and radical surgery is recommended. An American Samoan woman was air-evacuated to Tripler Army Medical Center for further evaluation and therapy after having undergone an exploratory laparotomy and right ovarian cystectomy. Her pathology at the time of her initial procedure revealed a mature cystic teratoma with a malignant degenerative component. Her diagnostic evaluation upon arrival was unremarkable except for her physical exam and pelvic CT. She subsequently underwent a radical surgical procedure to include a surgical staging procedure, revealing disseminated squamous cell carcinoma with FIGO stage III disease. Whereas malignant transformation of a benign cystic teratoma is a rare occurrence, a high index of suspicion should be maintained whenever a preoperative diagnosis is encountered; a radical surgical approach with en bloc resection should be employed. Adjuvant therapy with radiation or chemotherapeutic agents in general has not been shown to improve the outcome, especially in disseminated disease.
良性囊性畸胎瘤是一种非常常见的卵巢病变；它通常发生在女性的生育年龄，且大多为良性。然而，在大约1%至2%的病例中，它可能会发生恶性转化，预后很差。当出现播散性疾病时尤其如此。通常相关的恶性肿瘤是鳞状细胞癌，建议进行根治性手术。一名美属萨摩亚妇女在接受了剖腹探查术和右侧卵巢囊肿切除术后，被空运至特里普勒陆军医疗中心进行进一步评估和治疗。她初次手术时的病理显示为成熟囊性畸胎瘤伴恶性退变成分。她入院后的诊断评估除了体格检查和盆腔CT外无异常。她随后接受了包括手术分期的根治性手术，结果显示为伴有国际妇产科联盟（FIGO）III期疾病的播散性鳞状细胞癌。虽然良性囊性畸胎瘤的恶性转化很少见，但在遇到术前诊断时应保持高度怀疑；应采用整块切除的根治性手术方法。一般来说，放疗或化疗药物的辅助治疗尚未显示能改善预后，尤其是在播散性疾病中。
