Arora D S, Haldane S
Department of Histopathology, Royal Devon and Exeter Healthcare NHS Trust.
J Clin Pathol. 1996 Jun;49(6):519-21. doi: 10.1136/jcp.49.6.519.
A case of carcinosarcoma arising within an otherwise benign cystic teratoma is reported. The patient, a 78 year old nulliparous woman, presented with right sided abdominal pain of short duration and subsequently underwent a bilateral salphingo-oophorectomy. Slicing of the left ovary revealed a unilocular cyst containing hair admixed with soft yellow material with a thin wall apart from a solid area at one pole. Extensive areas of necrosis and cystic degeneration were present within this mass. Histologically, the large cyst was a typical mature cystic teratoma, containing carcinomatous and sarcomatous elements. Mature cystic teratomas have been reported in association with a variety of malignant ovarian tumours such as mucinous cystadenocarcinoma and malignant germ cell neoplasms. Secondary malignant transformation within a dermoid cyst is a much rarer occurrence, estimated as less than 2% of all such lesions. Adenocarcinomas are the second most common malignancies arising within dermoid cysts. Sarcomas alone or in combination with squamous carcinoma have been described arising in a mature cystic teratoma. To the best of our knowledge, no case of sarcoma arising in association with adenocarcinoma has been described before.
报告了一例发生于良性囊性畸胎瘤内的癌肉瘤病例。患者为一名78岁未生育女性，出现右侧腹部短时间疼痛，随后接受了双侧输卵管卵巢切除术。对左侧卵巢切片检查发现一个单房囊肿，内含毛发，混有柔软的黄色物质，除一极有实性区域外，囊肿壁薄。该肿块内存在广泛的坏死和囊性变区域。组织学检查显示，大囊肿为典型的成熟囊性畸胎瘤，含有癌性和肉瘤性成分。已有报道成熟囊性畸胎瘤与多种恶性卵巢肿瘤相关，如黏液性囊腺癌和恶性生殖细胞肿瘤。皮样囊肿内的继发性恶性转化更为罕见，估计占所有此类病变的比例不到2%。腺癌是皮样囊肿内第二常见的恶性肿瘤。已有文献描述成熟囊性畸胎瘤中出现单独的肉瘤或与鳞状细胞癌合并的情况。据我们所知，此前尚未有腺癌合并肉瘤的病例报道。
