报道 1 例卵巢无性细胞瘤并复习相关文献

厉莎 浙江¹, 王 良²
1、
2、浙江大学医学院附属第二医院妇科

摘要

目的：青春期是卵巢发育成熟、功能活跃时期，此时细胞增殖迅速，易受到体内外各种因素刺激发生突变，故青春
期是发生卵巢肿瘤的相对发病高峰。无性细胞瘤是一种少见的卵巢肿瘤，发病隐匿，患者多以盆腔肿物或腹痛就诊，目前
治疗方式以手术为主 , 但需考虑到大部分患者未婚未育，手术治疗应尽量保留患者生育及生理功能。本文报告一例 19 岁
青春期卵巢无性细胞瘤病例，患者因下腹胀痛就诊，超声提示盆腔巨大包块，相关肿瘤标志物（HCG、糖类抗原 125、
NSE）略升高，剖腹探查行术中冰冻病理示左侧卵巢无性细胞瘤，术中探查右侧卵巢及其余部位未见明显异常，结合患者
实际情况，故行左侧附件切除术及大网膜切除术。青春期卵巢肿瘤相较于成人有一致性及其特殊性，青春期因年龄、心理
的特殊性，心理的疏导同手术治疗一样不容忽视。通过回顾性分析本例青春期卵巢无性细胞瘤的诊治过程，复习相关文献，
以期提高对该病的认识，力争早诊早治，加强对青春期女性生殖系统疾患的关注及生育力保护。

关键词

青春期；卵巢肿瘤；无性细胞瘤；文献复习；生育力；病例报告

参考

[1]Parkinson CAHatcher HM Ajithkumar TV. Management of malignant ovarian germ cell tumors [J]. Obstet Gynecol Surv2011,66( 8) : 507-514.

[2]Tsuboyama THori YHori Met al. Imaging findings of ovarian dysgerminoma with emphasis on multiplicity and vascular architecture: pathogenic implications[J]. Abdom Radiol( NY) 201843( 7) : 1515-1523.

[3]Lazebnik N,Balog A,Bennett S, et al.Ovarian dysgerminoma: a challenging clinical and sonographic diagnosis[J]. J Ultrasound Med,2009,28(10): 1409-1415.

[4]Hyseni N, Llullaku S, Jashari H, et al. Advanced ovarian dysgerminoma infiltrating both ovaries and uterus in a 7-year-old girl[J]. Case Rep Oncol Med,2014,2014:910852.

[5]Roberts OA, Oranye BC. Ovarian dysgerminoma in an adolescent: a case report[ J]. Afr J Med Med Sci, 2013, 42(2): 197-200.

[6] 李婷 . 超声肿瘤形态学改变和多普勒血流及术中冰冻病理表现对卵巢肿瘤的评估价值 [J]. 实用癌症杂志 ,2018,33(11):69-72.

[7]Crum CP，Nucci MR，Howitt BE，et al. Diagnostic gynecologic and obstetric pathology[M]. 3rd ed. Amsterdam: Elsevier Medicine，2018: 949 - 1010.

[8]GerardoZCristinaBMariaGCetal.Survivalandreproductivefunctionaftertreatmentofmalignantgerm celovarian tumors [J].Journal of Clinical Oncology ,2006 19(2):1015-1020.

[9] 杨冬梓，石一复主编 . 小儿和青春期妇科学 [M]. 北京 : 人民卫生出版社，2003:208-211.

[10]Siegel RL，Miller KD，Fuchs HE，et al. Cancer Statistics, 2021[J]. CA Cancer J Clin，2021，71(1):7-33.

[11]von Allmen D. Malignant lesions of the ovary in childhood [J]. Semin Pediatr Surg, 2005, 14(2): 100-105.

[12]Andrés MM, Costa E, Cañete A, et al. Solid ovarian tumours in childhood: a 35-year review in a single institution [J]. Clin Transl Oncol, 2010, 12(4): 287-291.

[13]Kim SH, Kang SB. Ovarian dysgerminoma: color Doppler ultrasonographic findings and comparison with CT and MR imaging findings[J]. J Ultrasound Med, 1995, 14(11): 843-848.

[14] 肖榕 , 宋戈萍 . 卵巢生殖细胞肿瘤的 CT 及 B 型超声诊断 [J]. 中国医学影像学杂志 ,2007,15(1):15-18.

[15] 田冰 , 粟占三 . 卵巢无性细胞瘤 CD117 的表达及其鉴别诊断意义 [J]. 医学临床研究 ,2008,25(10):1839-1840.

[16] 卢金镶 , 申培红 , 张全武 , 等 . 卵巢无性细胞瘤 PLAP、NSE 和 PRL 检测的临床意义 [J]. 医学论坛杂志 ,2007,28(8):48-49.

[17] 范懿隽 , 周家德 . 卵巢无性细胞瘤的临床特点及预后影响因素 [J]. 安徽医科大学学报 ,2007,(02):215-218.

[18] 赵玲玲 , 赵涌 , 李圆圆 , 徐元浩 . 卵巢无性细胞瘤PLAP、NSE 和 WT1 检测的临床病理意义 [J]. 现代妇产科进展 ,2004,(02):117-119+163.

[19]Shaaban AM，Rezvani M，Elsayes KM，et al. Ovarian malignant germ cell tumors: cellular classification and clinical and imaging features[J]. Radiographics，2014，34: 777-801.

[20] 姚伶俐，张晓亮 , 孟波 , 等 . 卵巢无性细胞瘤 12 例临床病理及免疫组织化学观察 [J]. 安徽卫生职业技术学院学报 ,2018,17:106-108.

[21]Ebert KMHewitt GDIndyk JAet al. Normal pelvic ultrasound or MRI does not rule out neoplasm in patients with gonadal dysgenesis and Y chromosome material [J]. J Pediatr Urol,2018,14( 2) : 154.e1-154.e6.

[22]Kurman RJ，Carcangiu ML，Herrington CS，et al. WHO classification of tumours of female reproductive organs [M].4th.Lyon: IRAC Press，2014.57-58.

[23] 陶秀云 . 浅析卵巢无性细胞瘤 [J]. 继续医学教育 ,2007,(33):76-79.

[24]Nishio SUshijima KFukui Aet al.Fertility-preserving treatment for patients with malignant germ cel tumors of the ovary[J].J Obstet Gynaecol Res200632(4):416-421.

[25] El-Lamie IK,Shehata NA,Abou-Loz SK,et al. Conservative surgical management of malignant ovarian germ cel tumors:the experience of the Gynecologic Oncology Unit at Ain Shams University[J].Eur J Gynaecol Oncol2000,21(6):605-609.

[26] 李琎 , 李子庭 , 吴小华 . 卵巢恶性生殖细胞肿瘤复发相关因素分析 [J]. 中国癌症杂志 ,2006,(11):903-906.

[27]Di Tucci CCasorelli AMorrocchi Eet al. Fertility management for malignant ovarian germ cell tumors patients[J]. Crit Rev Oncol Hematol2017,120: 34 - 42.

[28]Brown J, Friedlander M, Backes FJ, et al. Gynecologic Cancer Intergroup (GCIG) consensus review for ovarian germ cell tumors [J]. Int J Gynecol Cancer, 2014, 24:S48-54.

[29] CerovacALjucaDNevacinovicEetal.Givingbirthafterfertility sparing treatment of embrional carcinoma FIGO IIIc: case report and literature review[J]. Med Arch201872( 5) : 371-373.

[30]Morice PDenschlag DRodolakis Aet al. Recommendations of the Fertility Task Force of the European Society of Gynecologic Oncology about the conservative management of ovarian malignant tumors[J]. Int J Gynecol Cancer201121( 5) : 951-963.

[31]Ray-Coquard IMorice PLorusso Det al. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosistreatment and follow-up[J]. Ann Oncol201829( Suppl 4) : iv1 - iv18.

[32] 王卡娜 , 刘辉 , 侯敏敏 , 等 .42 例卵巢恶性生殖细胞肿瘤临床特征及预后分析 [J]. 实用妇产科杂志 ,2015, 31(1):40~44.

[33]Chen Y, Luo Y, Han C, et al. Ovarian dysgerminoma in pregnancy: a case report and literature review [J]. Cancer Biol Ther, 2018,26:1-28.