mature cystic teratoma

成熟囊性畸胎瘤
  • 文章类型: Letter
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  • 文章类型: Case Reports
    成熟囊性畸胎瘤(MCT)是一种常见的卵巢肿瘤,在极少数情况下,进行恶性转化。已经发现,由于抗N-甲基-D-天冬氨酸受体(NMDAR)抗体的存在,MCT患者可能会出现精神症状,这是自身免疫性脑炎的根本原因。这里,我们介绍了第一例记录的抗NMDAR脑炎患者,该患者在MCT中也有低度胶质瘤形态.
    一名45岁女性出现癫痫发作,改变了意识,NMDAR抗体IgG滴度异常,和异常的脑MRI检查结果证实了抗NMDAR脑炎的诊断。体格检查显示,在子宫附件的超声检查中,左附件区域有一个椭圆形的混合回声肿块,大小为54×37mm。患者接受腹腔镜左卵巢和输卵管切除术。病理大体检查发现一堆灰红色囊性实性碎裂组织,大小7×6×2.2cm。组织学检查显示MCT的特征成分。此外,大体组织的固体成分显示出增殖和密集排列的星形胶质细胞,具有细胞异型性,GFAP和Olig-2阳性,IDH1和EMA阴性。Ki67指数大约是10%,提示存在低度胶质瘤病变。该患者被诊断为MCT恶性转化为低度胶质瘤的形态,未指定。卵巢肿瘤切除后,病人的精神症状得到改善。
    MCT内的低级别神经胶质瘤很少发生,抗NMDAR脑炎患者出现这种恶性转化的情况更为罕见.
    UNASSIGNED: Mature cystic teratoma (MCT) is a common type of ovarian tumors that can, in rare cases, undergo malignant transformation. It has been discovered that MCT patients may experience psychiatric symptoms due to the presence of anti-N-methyl-D-aspartate receptor (NMDAR) antibodies, which is the underlying cause of autoimmune encephalitis. Here, we present the first documented case of a patient with anti-NMDAR encephalitis who also had a morphology of low-grade glioma within MCT.
    UNASSIGNED: A 45-year-old woman presented with seizures, altered consciousness, abnormal NMDAR antibody IgG titers, and abnormal brain MRI findings confirm the diagnosis of anti-NMDAR encephalitis. Physical examination revealed an oval mixed echo mass measuring 54 × 37 mm in the left adnexal area on ultrasound of the uterine appendage. The patient underwent laparoscopic left ovarian and fallopian tube resection. The pathological gross examination revealed a pile of grayish-red cystic and solid fragmented tissue measuring 7 × 6 × 2.2 cm. Histological examination revealed characteristic components of MCT. Furthermore, the solid component of the gross tissue showed proliferative and densely arranged astrocytes with cellular atypia, which were positive for GFAP and Olig-2, negative for IDH1 and EMA. And the Ki67 index was approximately 10%, suggesting the presence of low-grade glioma lesions. The patient was diagnosed with malignant transformation of MCT into a morphology of low-grade glioma, not otherwise specified. After the removal of the ovarian tumor, the patient\'s psychiatric symptoms improved.
    UNASSIGNED: Low-grade glioma within MCT is a rare occurrence, and the presence of this malignant transformation in patients with anti-NMDAR encephalitis is even more uncommon.
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  • 文章类型: Case Reports
    Teratomas often occur in the gonads, while Extragonadal mature cystic teratomas are reported occasionally, with the most common site being the omentum. Teratoma in the Douglas sac is extremely rare. we report a rare case of mature cystic Teratoma in the Douglas sac in a 71-year-old woman who underwent laparoscopic surgery. A cyst with a diameter of approximately 6 cm from Douglas was found during surgery, and the mass was separated from both ovaries. Microscopically, the cyst was a mature cystic teratoma that did not originate from the ovary.
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  • 文章类型: Journal Article
    回顾性分析2008年至2019年温州医科大学附属第一医院手术治疗的27例成熟囊性畸胎瘤(MT-MCT)恶变患者和125例卵巢畸胎瘤伴扭转患者。这项研究中MT-MCT的发生率为0.79%。3年总生存率(OS)为69.6±9.6%。3年无进展生存率(PFS)为58.3±9.6%。Kaplan-Meier生存分析显示,鳞状细胞癌(SCC)患者的OS明显短于非SCC患者。年龄较大(OR1.076,95%CI1.041-1.111),较高的血小板(PLT)水平(OR1.012,95%CI1.005-1.020)和较低的中性粒细胞/淋巴细胞比率(NLR)水平(OR0.794,95%CI0.647-0.915)是MT-MCT的独立预测因子.联合使用年龄的曲线下面积(AUC),PLT计数和NLR为0.921(95%置信区间0.877-0.964;p<0.001),敏感性为92.6%,特异性为80.8%。
    This retrospective study was conducted in 27 patients with malignant transformation of mature cystic teratoma(MT-MCT)and 125 ovarian teratoma patients with torsion who underwent surgery in the First Affiliated Hospital of Wenzhou Medical University from 2008 to 2019. The incidence of MT-MCT in this study was 0.79%. The 3-year overall survival (OS) rate was 69.6 ± 9.6%. The 3-year progression-free survival (PFS) rate was 58.3 ± 9.6%. Kaplan-Meier survival analysis indicated that patients with squamous cell carcinoma (SCC) had significantly shorter OS compared with non-SCC patients. Older age (OR 1.076, 95% CI 1.041-1.111), higher platelet (PLT) level (OR 1.012, 95% CI 1.005-1.020) and lower neutrophil-to-lymphocyte ratio (NLR) level (OR 0.794, 95% CI 0.647-0.915) were independent predictors of MT-MCT. The area under the curve (AUC) for the combined use of age, PLT count and NLR was 0.921 (95% confidence interval 0.877-0.964; p < 0.001), with a sensitivity of 92.6% and a specificity of 80.8%.
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  • 文章类型: Journal Article
    未经证实:卵巢成熟囊性畸胎瘤(MCT)是孕妇中最常见的肿瘤。胎膜早破(PROM)是典型的妊娠并发症;然而,MCT和PROM之间的关系未知。因此,我们的目的是确定MCT是否与妊娠期PROM的发生有关.
    UNASSIGNED:回顾性分析2017年1月至2021年8月孕期附件肿块患者的资料。在剖宫产期间或阴道分娩后进行卵巢囊肿切除术。采用单因素和多因素logistic回归模型进行统计分析。
    UNASSIGNED:共纳入234例具有组织病理学结果的患者。在这些患者中,21在怀孕期间发生了PROM,其中11例被诊断为MCT。与其他亚型相比,MCT(p=0.025)与PROM有较强的相关性,是PROM的独立危险因素(比值比[OR],2.811;95%置信区间[CI],1.096-7.215;p=0.032)。此外,我们发现直径>5cm(p=0.0037)的MCT比直径<5cm的MCT更有可能促进PROM的发展。
    UNASSIGNED:MCT是妊娠期胎膜早破的独立危险因素。临床医师应充分考虑MCT孕妇的积极行动和预防性临床治疗,特别是那些直径≥5厘米的,减少与MCT相关的PROM相关的临床并发症。
    UNASSIGNED: Ovarian mature cystic teratomas (MCTs) are the most common tumors in pregnant women. The premature rupture of membranes (PROM) is a typical complication of pregnancy; however, the relationship between MCT and PROM is unknown. Therefore, we aimed to determine whether MCT is associated with the occurrence of PROM during pregnancy.
    UNASSIGNED: The data of patients with adnexal masses during pregnancy between January 2017 and August 2021 were retrospectively analyzed. Ovarian cystectomy was performed during cesarean delivery or after vaginal delivery. Univariate and multivariate logistic regression models were used for statistical analysis.
    UNASSIGNED: A total of 234 patients with histopathological results were included. Among these patients, 21 occurred PROM during pregnancy, of which 11 were diagnosed with MCT. Compared with other subtypes, MCT (p=0.025) showed a stronger correlation with PROM and was an independent risk factor for PROM (odds ratio [OR], 2.811; 95% confidence interval [CI], 1.096-7.215; p=0.032). Furthermore, we found that MCT with a diameter >5 cm (p=0.0037) was more likely to promote the development of PROM than those that with a diameter <5 cm.
    UNASSIGNED: MCT was an independent risk factor for PROM during pregnancy. Positive actions and preventative clinical treatments should be fully taken into consideration by clinicians for pregnant women with MCTs, especially those ≥5 cm in diameter, to reduce the clinical complications related to MCT-associated PROM.
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  • 文章类型: Journal Article
    目的:比较腹腔镜单部位手术(LESS)切除卵巢成熟囊性畸胎瘤(MCT)时倒刺缝合术(BS)与常规缝合术(CS)对围手术期病情及卵巢功能的影响。
    方法:本研究是一项于2019年5月至2020年10月在附属三级医院进行的综合队列研究。包括通过LESS膀胱切除术治疗单侧卵巢MCT的女性。在手术中应用BS或CS。
    结果:BS组和CS组的年龄匹配为1:1,体重指数和卵巢囊肿体积(每组40名妇女)。基线特征没有显著差异。平均手术时间(53.89±14.80versus67.93±19.23min,P=0.004)和缝合时间(11.85±6.68对19.76±12.75分钟,P=0.006),BS组明显短于CS组。基线时各组血清抗苗勒管激素(AMH)水平无显著差异,术后第1天,3个月,和12个月。然而,术后第1天、3个月血清AMH显著低于基线,两组均为12个月。
    结论:BS提供的手术和缝合时间比CS短,在卵巢MCT的LESS膀胱切除术中不增加对卵巢功能的损害。
    OBJECTIVE: To compare the effects of barbed suture (BS) and conventional suture (CS) on perioperative conditions and ovarian function in the excision of ovarian mature cystic teratoma (MCT) by laparo-endoscopic single-site surgery (LESS).
    METHODS: The present study is an ambispective cohort study conducted in an affiliated tertiary hospital between May 2019 and October 2020. Women treated by LESS cystectomy for unilateral ovarian MCT were included. BS or CS were applied in the surgery.
    RESULTS: BS and CS groups were matched 1:1 for age, body mass index and ovarian cyst volume (40 women per group). There were no significant differences in baseline characteristics. Mean operating time (53.89 ± 14.80 versuss 67.93 ± 19.23 min, P = 0.004) and suturing time (11.85 ± 6.68 versus 19.76 ± 12.75 min, P = 0.006) were significantly shorter in the BS group than the CS group. No significant differences were found in serum anti-Müllerian hormone (AMH) levels between groups at baseline, postoperative day 1, 3 months, and 12 months. However, serum AMH was significantly lower than baseline at postoperative day 1, 3 months, and 12 months in both groups.
    CONCLUSIONS: BS provides shorter operating and suturing time than CS, without increasing damage to ovarian function in LESS cystectomy for ovarian MCT.
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  • 文章类型: Case Reports
    原发性卵巢类癌是一种非常罕见的卵巢低度神经内分泌肿瘤,约占所有卵巢肿瘤的0.1%。
    我们报道了一例50岁女性因成熟囊性畸胎瘤引起的原发性卵巢类癌。评估左卵巢肿块的术中冷冻切片,并考虑恶性上皮肿瘤。形态学上,主要肿瘤由形成小梁的细胞组成,在主要部分附近观察到成熟的囊性畸胎瘤。免疫组织化学显示小梁细胞为泛细胞角蛋白弥漫性阳性,CD56和突触素具有较低的Ki-67指数(约1%)。
    仔细的形态学观察结合适当的辅助检查对于诊断由成熟的囊性畸胎瘤引起的原发性卵巢类癌至关重要。此外,讨论了原发性卵巢神经内分泌肿瘤的分类标准。
    Primary ovarian carcinoid is a very rare ovarian low-grade neuroendocrine tumor, accounting for about 0.1% of all ovarian neoplasms.
    We reported a case of primary ovarian carcinoid arising from a mature cystic teratoma in a 50-year-old woman. Intraoperative frozen section of left ovarian mass was assessed and a malignant epithelial tumor was considered. Morphologically, the main tumor was composed of cells forming trabeculae, and mature cystic teratoma was observed adjacent to the main part. Immunohistochemistry revealed that the trabecular cells were diffuse positive for pan Cytokeratin, CD56 and synaptophysin with low Ki-67 index (about 1%).
    Careful morphological observation combined with appropriate accessory examination are essential for the diagnosis of primary ovarian carcinoid arising from mature cystic teratoma. In addition, the classification criteria of the primary ovarian neuroendocrine tumor are discussed.
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  • 文章类型: Case Reports
    皮样囊肿是一种成熟的囊性畸胎瘤,仅包含一个胚层。它通常发生在头部和颈部,腹膜后皮样囊肿并不常见。畸胎瘤的特征是混合密度和钙化或气-液水平等特征。这里,我们介绍了一例40岁的女性,腹膜后脂肪肿块12.1cm×10.0cm,没有钙化,也没有其他畸胎瘤的特定特征。观察到薄且均匀的分离。在PET-CT上,它粘附于几个腹膜后器官,如左肾上腺和左肾,与主动脉等腹膜后血管关系密切,肠系膜上动静脉,左肾上动脉和下腔静脉。在PET-CT上,观察到轻度的18F-FDG摄取。基于上述影像学发现,我们考虑了脂肪肉瘤的临床诊断.剖腹手术和开放手术通过左垂直切口后,组织病理学检查显示腹膜后皮样囊肿。在为期2个月的随访中,患者恢复良好,没有不适和复发。比较皮样囊肿和脂肪肉瘤的影像学表现。在皮样囊肿中,可以有薄而均匀的分离,而不是线性的,脂肪肉瘤的局部和不规则的高密度。皮样囊肿和成熟的囊性畸胎瘤之间的区别尚待澄清。还对腹膜后皮样囊肿的临床和组织病理学特征进行了回顾,以提高诊断和管理水平。
    Dermoid cyst is a kind of mature cystic teratoma that contains only one germ layer. It usually occurs in the head and neck, retroperitoneal dermoid cysts are uncommon. Teratomas are characterized by mixed density and features like calcification or air-fluid level. Here, we present a case of 40-year-old female with a 12.1 cm × 10.0 cm retroperitoneal fatty mass which showed no calcification and few other specific characteristics of teratoma. Thin and uniform separations were observed. On PET-CT, it was adherent to several retroperitoneal organs like left adrenal gland and left kidney, and had a close relationship with several retroperitoneal vessels like aorta, superior mesenteric arteriovenous, left superior renal artery and inferior vena cava. On PET-CT, mild 18F-FDG uptake was observed. Based on the above imaging findings, a clinical diagnosis of liposarcoma was considered. After laparotomy and open surgery transit through a left vertical incision, the histopathologic examination revealed a retroperitoneal dermoid cyst. During a 2-month follow-up, the patient recovered well without discomfort and recurrence. Comparison between dermoid cyst and liposarcoma in imaging findings was performed. In dermoid cysts, there can be thin and uniform separations, rather than linear, localized and irregular high density in liposarcoma. The difference between dermoid cyst and mature cystic teratoma is yet to be clarified. A review of clinical and histopathological features of retroperitoneal dermoid cyst was also performed to enhance the level of the diagnosis and management.
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  • 文章类型: Case Reports
    我们报道了一例极为罕见的成人伴有二叶主动脉瓣的心内畸胎瘤。一名37岁男子因慢性胸闷和心悸加重被转诊到我院后,意外在右心室发现了一个小肿块。在重复经胸超声心动图检查提示室间隔存在占位病变后,我们进行了手术探查并切除了病变。病理证实为成熟的囊性畸胎瘤。在半年的后续行动中,没有症状报告。该病例是成人二叶主动脉瓣最小的原发性心内畸胎瘤的第一份报告。
    We reported an exceedingly rare adult case of intracardiac teratoma with a bicuspid aortic valve. A small mass was discovered in the right ventricle of a 37-year-old man by accident after he was referred to our hospital due to chronic chest distress and aggravated palpitation. We performed a surgical exploration with excision of the lesion after a repeat transthoracic echocardiography suggested a space-occupying lesion in the interventricular septum. A mature cystic teratoma was pathologically confirmed. During the half-year follow-up, no symptoms were reported. This case constitutes the first report of the smallest primary intracardiac teratoma in an adult with a bicuspid aortic valve.
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  • 文章类型: Case Reports
    BACKGROUND: Mature cystic teratoma (MCT) with meningioma of the ovary is a very rare benign tumor. There is only 3 reports of this disease until June 2019. The aim of the present study was to describe a ovarian mature cystic teratoma containing meningioma and nests of neuroblasts in a 15-year-old girl.
    METHODS: The method used in the present study consists of description of the clinical history, image lab features, and pathological result.
    RESULTS: The patient complained of a 2-month history of irregular vaginal bleeding. Abdominal computed tomography (CT) showed a large oval cystic-solid mass with septations and fat density shadow, in abdomen pelvic cavity. The cystic part was the main component in the mass. The tumoral solid parts and its internal division could be seen intensified from slight to moderate on contrast-enhanced CT images compared with those on precontrast images, and the solid parts showed heterogeneous enhancement. Neighbouring intestinal tract and the uterus displaced by compression. The pathological examination confirmed the diagnosis.
    CONCLUSIONS: The clinical feature of ovarian mature cystic teratoma with meningioma includes a lack of specificity. Only meticulous recording of the gross features, histopathological examination including immunohistochemistry and supportive clinical and radiological findings to arrive at a correct diagnosis in case of unconventional tumours. If necessary, preoperative puncture can be performed.
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