妇产
词汇介绍
拓展阅读
解析
teratoma 英 [,terə'təʊmə] 美 [,terə'təumə]
释 义 畸胎瘤;卵巢畸胎瘤;囊性畸胎瘤
例 句 Their tumor pathologies included benign or malignant thymoma and teratoma. 他们的肿瘤病理包括良性或恶性胸腺瘤和畸胎瘤。
概述
概述
畸胎瘤是卵巢肿瘤中常见的一种,来源于生殖细胞,分为成熟畸胎瘤(即良性畸胎瘤)和未成熟性畸胎瘤(恶性畸胎瘤)。良性畸胎瘤里含有很多种成分,包括皮肤、毛发、牙齿、骨骼、油脂、神经组织等;恶性畸胎瘤分化欠佳,没有或少有成形的组织,结构不清。早期畸胎瘤多无明显临床症状,大多是体检时偶然发现。卵巢成熟性畸胎瘤(MCTO),亦称皮样囊肿,是育龄期女性最常见的生殖细胞肿瘤 ,约占卵巢肿瘤10%~20%。MCTO可由一个或多个胚层的成熟组织组成,为卵巢良性肿瘤, 罕有恶性变,文献报道恶变率为1%~2%。
症状体征
此类肿瘤如果较小或无功能,通常无特异性临床表现。早期症状主要包括腰背疼痛、双下肢运动感觉及其反射异常、阳萎及膀胱与直肠括约肌功能障碍。与椎管内其他肿瘤相比较,此类肿瘤患者除发病年龄较轻,病程较长等情况外,还有如下特点:①因为囊肿主要位于脊髓下段,圆锥和马尾部较多,所以腰腿疼痛者较多,常呈钝痛或剧烈神经根性痛;②直肠膀胱功能障碍者较多,约80%以上的病人有排尿排便功能障碍;③运动系统损害可不典型,当囊肿合并腰骶部脊柱裂时,脊髓下端常被固定于较低部位;④若合并皮毛窦时,常可以引发颅内感染,亦有少数皮毛窦者,由于囊内容物刺激引起发热等表现。
治疗
畸胎瘤一旦确诊,必须争取早期手术切除,以避免良性畸胎瘤因耽搁手术而导致肿瘤恶变,同时可预防肿瘤感染、破裂、出血及并发症的发生。畸胎瘤的手术要点是完整地切除肿瘤,卵巢和睾丸肿瘤均作一侧卵巢或睾丸切除,骶尾部畸胎瘤强调务必将尾骨一并切除,以免残留多能细胞而导致肿瘤复发。
并发症和预后
畸胎瘤通常合并其他先天畸形,如脊柱裂、腰背部皮肤和软组织异常,少数可有内脏畸形。良性畸胎瘤手术切除后预后亦较好。对于椎管内成熟型的畸胎瘤产生的类癌瘤,预后尚不明确。若它们的生物学行为有恶性特征,则手术切除后应辅助放疗,近期疗效有改善,远期疗效尚不确定。
从阑尾腺癌到卵巢成熟畸胎瘤的肿瘤到肿瘤转移,模仿畸胎瘤的恶性转化: 病例报告
发表时间:2019-08-14
影响指数:2.5
作者: Mitsutake Yano
期刊:Diagnostic Pathology
Ovarian mature teratomas (OMTs) are common tumors that account for 20% of all ovarian neoplasms. An OMT is a germ cell tumor composed of cells derived from at least two, but frequently all three, germ cell layers. Although OMTs are usually benign, 1–3% undergo malignant transformation. Adenocarcinoma arising in OMTs is the second most common malignancy after squamous cell carcinoma and accounts for 7% of all cases, with most tumors arising from the gastrointestinal and respiratory-type epithelium. Metastatic adenocarcinoma from various organs is also often encountered in the ovary. Approximately 15% of all malignant neoplasms of the ovary are of the metastatic origin, and the gastrointestinal tract is the most common primary site (39%), followed by the breast (28%) and uterine endometrium (20%). The presence of an ovarian mass is sometimes the first manifestation of clinically occult non-ovarian primary cancer. Therefore, when adenocarcinoma is encountered in OMTs, we need to decide whether it is primary or metastatic.
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