Seidman J D, Elsayed A M, Sobin L H, Tavassoli F A
Department of Gynecologic and Breast Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
Am J Surg Pathol. 1993 Jan;17(1):22-34. doi: 10.1097/00000478-199301000-00003.
Twenty-five patients with mucinous tumors of the ovary and appendix were studied. The average age of the patients was 52 years, and the ovarian and appendiceal tumors were discovered synchronously in all but two cases. The majority had either a pelvic mass or abdominal or pelvic pain. A high frequency of bilateral ovarian tumors (11/25), and right-sided predominance for the unilateral ovarian tumors (nine right, five left) were found. Four patients had ovarian mucinous carcinomas, 10 had mucinous tumors of low malignant potential, 10 had mucinous cystadenomas, and one had a mucinous cyst. Pseudomyxoma ovarii was present in 22 cases. Twenty-two of 24 appendices were grossly abnormal. There were six appendiceal mucinous adenocarcinomas, 10 mucinous tumors of uncertain malignant potential, seven mucinous cystadenomas, one hyperplastic polyp, and one mucocele. Twelve patients had ovarian and appendiceal tumors of similar malignant potential, nine had appendiceal tumors with more aggressive morphologic features than the corresponding ovarian tumor, and four had ovarian tumors with more aggressive morphologic features than the appendiceal tumor. Eighteen patients had peritoneal involvement by mucinous epithelium admixed with mucus (nine localized, nine diffuse). Immunoperoxidase reactions for four epithelial antigens in 15 cases showed complete concordance between ovarian and appendiceal lesions in only five cases and were not helpful in determining the site of origin of the peritoneal tumor. Our findings suggest an independent origin of the ovarian and appendiceal tumors in most cases and do not favor an origin in a single site. Furthermore, it is proposed that the peritoneal lesions may arise de novo as part of a multifocal neoplastic process.
对25例卵巢和阑尾黏液性肿瘤患者进行了研究。患者的平均年龄为52岁，除2例以外，所有患者的卵巢和阑尾肿瘤均为同时发现。大多数患者有盆腔肿块或腹部或盆腔疼痛。发现双侧卵巢肿瘤的发生率较高（11/25），单侧卵巢肿瘤以右侧为主（右侧9例，左侧5例）。4例患者为卵巢黏液癌，10例为低恶性潜能黏液性肿瘤，10例为黏液性囊腺瘤，1例为黏液囊肿。22例存在卵巢假黏液瘤。24例阑尾中有22例大体异常。有6例阑尾黏液腺癌，10例恶性潜能不确定的黏液性肿瘤，7例黏液性囊腺瘤，1例增生性息肉和1例黏液囊肿。12例患者的卵巢和阑尾肿瘤具有相似的恶性潜能，9例患者阑尾肿瘤的形态学特征比相应的卵巢肿瘤更具侵袭性，4例患者卵巢肿瘤的形态学特征比阑尾肿瘤更具侵袭性。18例患者的腹膜有黏液上皮伴黏液浸润（9例局限，9例弥漫）。对15例患者的4种上皮抗原进行免疫过氧化物酶反应，结果显示仅5例卵巢和阑尾病变完全一致，对确定腹膜肿瘤的起源部位并无帮助。我们的研究结果表明，大多数情况下卵巢和阑尾肿瘤起源独立，不支持单一起源。此外，有人提出腹膜病变可能作为多灶性肿瘤过程的一部分而新生。
