卵巢粒层细胞瘤的肉瘤变

卵巢粒层细胞瘤为低度恶性、切除后可复发的肿瘤。预后差者见于诊断时已有卵巢外扩散。其组织学表现与预后无关。此瘤的肉瘤变系首例报告,伴罕见的快速死亡。患者66岁,因子宫肌瘤于47岁已作单纯性子宫切除。下腹不适已两周;经阴道检查显示双卵巢肿块。剖腹探查见卵巢由瘤组织替代;肿块左8.0×5.0×4.5cm;右12.0×8.0×7.0cm:切面软、主为实性浅褐色伴小囊性区,可见坏死、出血灶。大网膜见两处小肿瘤沉积。组织学上具有粒层细胞瘤的特征,瘤组织主为伴均质、着色浅、卵园、有角常有沟的核的小细胞成波纹状弥散排列,并形成有规则的粒层瘤细胞片组成。少许区域见伴Call-     

卵巢间质黄体瘤一例报告并文献复习

卵巢类固醇细胞瘤是一种少见的卵巢肿瘤,约占卵巢肿瘤≤0.1%,根据其肿瘤组织的来源分为间质黄体瘤、Leydig细胞瘤、非特异性类固醇细胞瘤3类。卵巢间质黄体瘤是临床少见疾病,其无特异性表现,彩色超声和影像学检查不易查出,容易造成术前误诊、漏诊。本文回顾性分析我院收治的卵巢间质黄体瘤临床资料并进行相关文献复习,卵巢间质黄体瘤的确诊需结合临床表现及术后病理,手术是其主要治疗方法。     

卵巢间质黄体瘤一例报告并文献复习

卵巢类固醇细胞瘤是一种少见的卵巢肿瘤,约占卵巢肿瘤≤0.1%,根据其肿瘤组织的来源分为间质黄体瘤、Leydig细胞瘤、非特异性类固醇细胞瘤3类。卵巢间质黄体瘤是临床少见疾病,其无特异性表现,彩色超声和影像学检查不易查出,容易造成术前误诊、漏诊。本文回顾性分析我院收治的卵巢间质黄体瘤临床资料并进行相关文献复习,卵巢间质黄体瘤的确诊需结合临床表现及术后病理,手术是其主要治疗方法。     

卵巢恶性生殖细胞瘤近期治疗结果:附34例病例研究分析

对泰国一个医院中罕见的卵巢恶性生殖细胞瘤(mOGCT)患者存活率和手术治疗结果进行回顾性研究。选择1990～1996年病理诊断为卵巢恶性生殖细胞瘤(mOGCT)的34例妇女。手术治疗原则:初次手术为子宫全切术—双侧输卵管卵巢切除术(TAH.BSO)的非保守术或单侧输卵管卵巢切除(USO)的保守术(用于年轻妇女保留生育功能),晚期病例配合细胞减灭术。并行结肠下网膜切除术、腹腔液细胞学检查、对可疑部位进行活检。 纯无性细胞瘤(DgS)IA期单行USO,IB～Ⅱ期行TAH.BSO后化疗3～4疗程,ⅡC～Ⅳ期晚期病例术后化疗4～6疗程。化疗无效者进一步给予     

卵巢粒层细胞瘤62例临床分析

卵巢粒层细胞瘤为低～中度恶性肿瘤 ,占卵巢肿瘤的1 1% [1] ,患者预后多数较好 ,但部分有远期复发或转移倾向 ,初次诊断时很难判断其生物学行为。现对 6 2例卵巢粒层细胞瘤进行回顾性分析 ,探讨其临床特点及预后。1　资料和方法1 1一般资料　 1970～ 1988年两院共收治卵巢肿瘤 2 85 7例 ,其中经手术并有病理证实的粒层细胞瘤 6 2例 ,占 0 .2 1%。所有标本均经病理科专家复核 ,并进行组织学分级 ,查阅病历 ,获得临床资料。1.2　治疗方法　本组病例均行手术治疗 ,单侧附件切除术31例 ,全子宫 双附件切除术 2 6例 ,肿瘤细胞减灭术 5例。Ｉｃ期…     

易与库肯勃瘤混淆的几类卵巢原发性肿瘤

库肯勃瘤是恶性程度极高的卵巢转移性肿瘤,早期即可有广泛的浸润和转移,预后不佳。临床上可见一些少见的卵巢原发性肿瘤,如卵巢印戒细胞间质瘤、硬化性间质瘤、黏液性类癌、透明细胞癌,在病理学上也可见特征化的印戒细胞,易与库肯勃瘤混淆。这需要在临床症状,体征,病理学,免疫组织学及影像学等多方面进行正确鉴别。库肯勃瘤的治疗方法主要为手术,故争取提高术前诊断准确率,对于提高患者的生存率有重要的意义。     

637例直径≤5cm卵巢肿块的病理组织学类型分析及处理

目的:调查分析直径≤5cm卵巢肿块的病理组织学类型。方法:回顾分析经手术剔除且经常规病理组织学检查确诊的直径≤5cm卵巢肿块的临床资料。结果:卵巢肿瘤323例(50.71%),其中,良性肿瘤297例(46.62%),恶性肿瘤23例(3.61%),交界性肿瘤3例(0.47%)。瘤样病变314例(49.29%)。结论:直径≤5cm卵巢肿块中卵巢肿瘤和卵巢瘤样病变占绝大多数,卵巢瘤样病变中黄体囊肿、黄素囊肿、滤泡囊肿、卵巢冠囊肿、卵泡囊肿和包涵囊肿等占44.27%,可不必处理,但临床上应予以重视。     

易与库肯勃瘤混淆的几类卵巢原发性肿瘤

库肯勃瘤是恶性程度极高的卵巢转移性肿瘤,早期即可有广泛的浸润和转移,预后不佳.临床上可见一些少见的卵巢原发性肿瘤,如卵巢印戒细胞间质瘤、硬化性问质瘤、黏液性类癌、透明细胞癌.在病理学上也可见特征化的印戒细胞,易与库肯勃瘤混淆.这需要在临床症状.体征,病理学.免疫组织学及影像学等多方面进行正确鉴别.库肯勃瘤的治疗方法主要为手术,故争取提高术前诊断准确率,对于提高患者的生存率有重要的意义.     

卵巢幼年型颗粒细胞瘤四例临床分析

目的 探讨卵巢幼年型颗粒细胞瘤的诊断,治疗和预后。方法 回顾性分析自1983年至2002年间北京协和医院收治的4例卵巢幼年型颗粒细胞瘤的临床资料。结果 卵巢幼年型颗粒细胞瘤的发生率极低,主要发生在青少年及儿童,临床表现为盆腔实性包块伴胸腹水,4例患者雌二醇水平均在正常范围,手术病理分期为Ⅰ期。确诊主要依据病理检查,所有患者接受手术 化学药物治疗（化疗）。其中,2例呈高核分裂相的患者病情很快恶化,分别于发病后10和14个月死亡;2例低分裂相的患者现无瘤生存分别为32和25个月。结论 卵巢幼年型颗粒细胞瘤的诊断主要依据病理检查,核分裂相高者预后不良,治疗以手术为主,辅以化疗可能改善预后。     

12例卵巢卵黄囊瘤临床及超声表现分析

目的:探讨卵巢卵黄囊瘤的临床与超声特点,评价彩色多普勒超声诊断卵巢卵黄囊瘤的临床应用价值。方法:回顾性分析12例经手术病理检查证实为卵巢卵黄囊瘤患者的临床及超声表现。结果:①12例患者年龄14～44岁,临床主要表现为中下腹胀、盆腔包块、下腹痛等。病程在1月之内10例。术前10例患者行血清甲胎蛋白(AFP)检测,其水平均高于正常;12例中8例患者血清CA125增高。卵巢卵黄囊瘤均为单发,其中7例为单纯卵巢卵黄囊瘤,5例为含有卵黄囊成分的卵巢恶性混合型生殖细胞肿瘤。FIGO分期:ⅠA期4例,ⅠC期5例,ⅡC期1例,ⅢC期2例。②超声检查见12例患者的肿块最大径线为71～185mm,其中实性肿块4例,囊实性肿块7例,囊性肿块1例。超声图像显示包块边界清晰,大部分呈椭圆形;实性部分彩色血流信号丰富,其中2例甚至见动静脉瘘;7例含有大量的盆腹腔积液,其中2例伴胸腔积液。结论:卵巢卵黄囊瘤主要发生于青春期及育龄期女性,病程快,伴有血清AFP水平明显增高。彩色多普勒超声检查有助于对本病的诊断和鉴别。     

Unilateral massive ovarian edema (MOE): a case report

Massive ovarian edema is an unusual cause of ovarian enlargement in young patients. Venous end lymphatic obstruction producing edema is thought to be the reason for enlargement of the ovaries in most cases. We report the case of a 23-year-old woman with unilateral massive ovarian edema, findings on ultrasound imaging, and a review of the literature. The ultrasound findings have been reported as a solid tumour-like mass or as a solid mass containing a cystic component, which is non-specific and can mimic neoplasia. Thus, the definitive diagnosis requires histological examination. Because conservative treatment with preservation of the ovaries is often possible, ovarian edema is an important condition to consider in a young patient with a complex but non-specific ovarian mass and appropriate preoperative clinical treatment should be started.     

The association of enchondromatosis with malignant transformed chondrosarcoma and ovarian juvenile granulosa cell tumor (Ollier disease)

Objective

Ovarian juvenile granulosa cell tumor has an interesting association with multiple enchondromatosis (Ollier disease and Maffucci syndrome) and should be considered a leading diagnosis when an ovarian mass is found in young patients with these conditions. Besides the association with nonskeletal malignancies, there is a high risk of malignant transformation of enchondroma in chondrosarcoma as was also the case in this instance.

Growing teratoma syndrome vs chemotherapeutic retroconversion: case report and review of the literature

BACKGROUND: Immature ovarian teratoma is the third most common germ cell tumor (GCT) following dysgerminoma and endodermal sinus tumor. The treatment of choice during childbearing age for immature teratoma composes of unilateral oophorectomy and in case of metastatic disease postoperative chemotherapy (BEP). Finding a solid mass in the peritoneal or chest cavity during routine follow up raises the suspicion of distance recurrence. DiSaia was the first to describe the appearance of benign distant metastasis during routine follow up. He termed this phenomenon "chemotherapeutic retroconversion". Latter, Logothetis described what seems to be a similar phenomenon in testicular non-seminomatous germ cell tumor (NSGCT) that he called the "growing teratoma syndrome". CASE: We present a case of a 12-year-old girl treated for growing teratoma syndrome after primary ovarian GCT. CONCLUSION: Review of the literature shows that this syndrome and the "chemotherapeutic retroconversion" are probably the same phenomenon.     

Sertoli–Leydig cell tumor in a 12-year-old girl: a review article and case report

Background

The Sertoli and Leydig cell tumor is an unusual neoplasm that belongs to the sex cord-stromal tumors. Generally these tumors are associated with good prognosis. These tumors usually present virilizing symptoms such as oligomenorrhea or amenorrhea, hirsutism, voice raucity, laryngeal protuberance and clitoromegaly.

Case presentation

A 12 year old girl referred acute abdominal pain with no other clinical manifestations. An abdominal ultrasound showed a semisolid mass suggestive of ovarian tumor. The diagnosis was confirmed by a computed tomography. A unilateral salpingo oophorectomy was performed and the pathologist reported a Sertoli-Leydig tumor with intermediate differentiation. The outcome was excellent.

Conclusions

These tumors represent a rare condition in children. However, they can occur at any age, therefore it is important to acknowledge the clinical manifestations, diagnostic approach and therapeutic options. In this case the patient presented unusual symptoms which makes it more interesting.     

Juvenile granulosa cell tumor of the ovary associated with hypercalcemia

Introduction Juvenile granulosa cell tumors (JGCTs) are rare ovarian neoplasms that typically occur in children and young women. While most JGCTs are diagnosed in Stage IA and can be cured by unilateral oophorectomy alone, the remainders are diagnosed in more advanced stages and may exhibit aggressive behavior despite surgery and chemotherapy. Paraneoplastic hypercalcemia occurs in 5% of ovarian malignancies with small cell and clear cell carcinoma being the commonest ovarian tumors associated with hypercalcemia. Only one case of ovarian JGCT associated with hypercalcemia has previously been documented in the literature. Case report A 25-year-old married childless woman presented with a unilateral ovarian mass associated with profound hypercalcemia and suppressed serum parathyroid hormone-intact (PTH-i) level. After rectifying the hypercalcemia with saline hydration, furosemide, and anti-hypercalcemic drugs, the patient underwent unilateral salpingo-oophorectomy that demonstrated Stage IC ovarian JGCT. The patient received adjuvant chemotherapy with three courses of BEP (bleomycin, etoposide and cisplatin) and to date, ten months after surgery, she is disease-free, eucalcemic, and menstruating normally. Conclusion This is the second case reported in the literature of ovarian JGCT associated with hypercalcemia. Since serum PTH-i level was suppressed and the hypercalcemia did not recur after resection of the tumor, it is concluded that the hypercalcemia was caused by parathyroid hormone-related protein (PTH-rP) produced by the tumor. It seems that unilateral salpingo-oophorectomy followed by BEP chemotherapy is an appropriate treatment for unilateral Stage IC ovarian JGCT in women desiring to preserve ovarian function and childbearing capacity.     

儿童卵巢无性细胞瘤一例并文献复习

儿童卵巢无性细胞瘤在临床较少见,结合病史及辅助检查综合考虑,手术在儿童卵巢无性细胞瘤中是首选方法。随着综合治疗模式的发展,需要考虑手术治疗后对于儿童生育力的保护及卵巢恶性肿瘤的管理。报告1例12岁儿童卵巢无性细胞瘤病例,患者因下腹胀痛首次就诊于延安大学附属医院儿科,发现盆腔包块后就诊于妇科,肛门指诊示盆腔偏右侧可触及约7.0 cm×6.0 cm包块,质中,边界尚清,活动可,相关肿瘤标志物（甲胎蛋白、糖类抗原125）略升高,剖腹探查行术中冰冻病理所示考虑左侧卵巢良性病变,右侧卵巢恶性病变,故行右侧附件切除术+左侧卵巢囊肿剥除术,术后给予辅助化疗同时给予戈舍瑞林去势保护卵巢功能治疗。现已随访11个月,患者月经规律,无特殊不适。通过回顾性分析儿童卵巢无性细胞瘤诊治过程及特点,以期提高临床医师对该病诊断、治疗及管理的认识。     

Neonatal ovarian lymphangioma

Ovarian cysts are primarily of follicular origin and ovarian lymphangioma is an extremely rare lesion. We report a case of prenatal diagnosis of unilateral ovarian cyst in which pathologic examination revealed an ovarian lymphangioma. Ovarian cystic lymphangioma should be included in the differential diagnosis of an ovarian cyst mass in neonate.     

Laparoscopic treatment of ovarian tumors in children: an experience of seven cases in Mansoura University Hospital

All ovarian tumors in children are rare. Laparoscopic ovary-sparing treatment of ovarian tumor would be the preferred surgical approach for children in order to preserve future fertility. The objective of this research is to study the experience of gynecology department in Mansoura University Hospital in laparoscopic treatment of ovarian tumors in children. This study included seven patients with age range of 7 to 11 years presented with ovarian tumors. The following items were fulfilled for all studied cases: age at diagnosis, presenting complaints, blood samples for detection of tumor markers, abdominal ultrasonography, abdominal magnetic resonance imaging (MRI), treatment by laparoscopy, histopathological examination, and the outcome of the patients. All ovarian tumors were benign. Three cases were found to be cystic teratomas, two cases were benign serous cystadenoma, only one case was cystadeno-fibroma and one case was solid tumor, and its histology did not give a clear diagnosis, but no malignant cells were found. Unilateral salpingo-oophorectomy was carried out in three patients, whereas the other four patients had unilateral ovarian cystectomy. In one case, intraoperative spillage during excision of the tumoroccurred. Recovery of all patients was good and without any complications. Laparoscopic conservative surgery as a treatment for benign ovarian tumor in childhood gives a good chance to preserve future fertility.     

Malignant epithelioid ovarian schwannoma: a case report

Abstract.   LászlóÁ, Ivaskevics K, Sápi Z. Malignant epithelioid ovarian schwannoma: a case report. Int J Gynecol Cancer 2006; 16(Suppl. 1): 360–362.
There are only a few cases reported in the literature about schwannoma originating from the ovary. The patient was registered to the hospital due to a painless solid tumor in her left axillary region. Histologic examination of the excised tumor showed reticulum cell sarcoma. Two years later, oophorectomy was performed due to a unilateral ovarian tumor. The results of the histologic examination with different staining were particularly the same as those found in the axillary tumor, finally diagnosed as a malignant epithelioid schwannoma of the ovary. Our case report may be of interest for three reasons: 1) malignant schwannoma of the ovary is a very rare tumor, 2) the epithelioid type of the tumor may cause a differential diagnostic problem, and 3) clinical appearance of the metastasis was quite unusual, also resulting in difficulties in the appropriate diagnosis.     

Ovarian neuroendocrine carcinoma, non-small cell type, associated with serous carcinoma

BACKGROUND: Neuroendocrine carcinoma of the non-small cell type of the ovary is a rare aggressive tumor, interestingly associated with either a surface epithelial tumor or teratoma. CASE: A 71-year-old woman presented with a pelvic mass and underwent a total abdominal hysterectomy with a bilateral salpingo-oophorectomy. Pathology examination showed a 6.5 cm in greatest dimension ovarian tumor composed of neuroendocrine carcinoma of the non-small cell type and serous carcinoma. Immunohistochemical studies including keratin 7, WT-1, and neuroendocrine markers demonstrated differences in the two components. Microsatellite instability (MSI) analysis using five polymorphic markers also showed a different pattern in the two components. CONCLUSION: This is the first report of an ovarian neuroendocrine carcinoma, non-small cell type, associated with a serous carcinoma. Immunohistochemistry and MSI are very helpful in making a definite diagnosis.