Pins M R, Young R H, Daly W J, Scully R E
James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Boston, USA.
Am J Surg Pathol. 1996 Jul;20(7):823-33. doi: 10.1097/00000478-199607000-00005.
A total of 37 cases of ovarian primary squamous cell carcinoma (SCC)-19 associated with a dermoid cyst (SCCD), seven associated with endometriosis (SCCE), and 11 pure (SCCP)-are described. The last 18 cases belong within the new World Health Organization category of SCC in the surface epithelial-stromal category. The 19 patients with SCCD were 21-75 (mean, 52) years old; three of the carcinomas were in situ and seven, six, and three tumors were stages I, II, and III, respectively. The tumors and associated dermoid cysts were 6-35 cm in greatest dimension, usually forming mural nodules with intracavitary protrusion and focal necrosis and hemorrhage; two, seven, and seven tumors were grades 1, 2, and 3, respectively. SCCD was focally associated with a columnar epithelial cyst lining in 13 cases, suggesting an origin therein. One patient with stage I, grade 1 SCCD also had squamous cell carcinoma in situ (CIS) of the cervix. The seven patients with SCCE were 29-70 (mean, 49) years old, and one, three, one, and two tumors were stages I, II, III, and IV, respectively; all of the tumors were grade 3. One was associated with squamous cell carcinoma in situ of the cervix. The 11 patients with SCCP were 27-73 (mean, 56) years old, and one, four, five, and one tumors were stages I, II, III, and IV, respectively. The tumors were 6-26 cm in greatest diameter, usually solid with focal necrosis; one and 10 tumors were grades 2 and 3, respectively. Three patients with SCCP also had cervical squamous cell carcinoma in situ. The patients with SCCE had a poorer overall survival than those with SCCD. Five of the six patients with SCCE for whom adequate follow-up information was available died of their disease (mean survival, 5 months); also, in all five cases of SCCE reported in the literature, the patients died of their disease (mean survival, 4 months). The stage of the tumor and its grade correlated best with overall survival for all three types of SCC.
本文描述了37例与皮样囊肿相关的卵巢原发性鳞状细胞癌（SCC）-19、7例与子宫内膜异位症相关的（SCCE）以及11例纯原发性鳞状细胞癌（SCCP）。最后18例属于世界卫生组织新分类中的表面上皮-间质类鳞状细胞癌。19例SCCD患者年龄在21至75岁（平均52岁）之间；其中3例癌为原位癌，7例、6例和3例肿瘤分别为Ⅰ期、Ⅱ期和Ⅲ期。肿瘤及相关皮样囊肿最大直径为6至35厘米，通常形成壁结节，伴有腔内突出、局灶性坏死和出血；2例、7例和7例肿瘤分别为1级、2级和3级。13例SCCD局部与柱状上皮囊肿内衬相关，提示起源于此。1例Ⅰ期Ⅰ级SCCD患者宫颈也有原位鳞状细胞癌（CIS）。7例SCCE患者年龄在29至70岁（平均49岁）之间，1例、3例、1例和2例肿瘤分别为Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期；所有肿瘤均为3级。1例与宫颈原位鳞状细胞癌相关。11例SCCP患者年龄在27至73岁（平均56岁）之间，1例、4例、5例和1例肿瘤分别为Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期。肿瘤最大直径为6至26厘米，通常为实性，伴有局灶性坏死；1例和10例肿瘤分别为2级和3级。3例SCCP患者宫颈也有原位鳞状细胞癌。SCCE患者的总生存期比SCCD患者差。有足够随访信息的6例SCCE患者中有5例死于该病（平均生存期5个月）；此外，文献报道的所有5例SCCE患者均死于该病（平均生存期4个月）。对于所有三种类型的鳞状细胞癌，肿瘤分期及其分级与总生存期的相关性最佳。
