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1、卵巢成熟性畸胎瘤恶变的临床特点和诊断新进展梁硕吴南朱兰卵巢成熟性畸胎瘤(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％[1-4]。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％[1-4]。恶变的原因不明，现将本病的临床特点及诊断进展综述如下。一、组织病理学大体：恶变的MCTO与MCTO表现相似，亦为囊性包块，内含大量毛发、油脂、牙齿等不同胚层来源组织。不同之处表现为：(1)恶变MCTO囊壁表面粗糙呈颗粒状；(2)具有侵袭性，可穿透全层囊壁，并
2、与周围脏器粘连。病理剖检示恶变常发生在囊内壁上的实性结节（“头节”）或者囊壁增厚的部分[3，5]。因此，术中需仔细检查囊壁，发现结节或囊壁增10.3760/cma.j.issn.0376-2491.2011.39.020作者单位：100730中国医学科学院北京协和医学院（梁硕、吴南）；北京协和医院妇产科（朱兰）万方数据@@[1]SakumaM,OtsukiT,YoshinageK,etal.Malignanttransformationarisingfrommaturecysticteratomaoftheovaryaretros
3、pectivestudyof20cases.IntJGynecolCancer,2010,20:766-771.@@[2]DosSantosL,MokE,lasonosA,etal.Squamouscellcarcinomaarisinginmaturecysticteratomaoftheovary:acaseseriesand万方数据reviewoftheliterature.GynecolOncol,2007,105:321-324.@@[13]EmotoM,ObamaH,HofiuchiS,etal.Transvagina
4、lcolor@@[3]ParkJY,KimDY,KimJH,etal.MalignanttransformationofDopplerultrasoniccharacterizationofbenignandmalignantovarianmaturecysticteratomaoftheovary:experienceatasinglecysticteratomasandcomparisonwithserumsquamouscellinstitution.EurJObstetGynecolReprodBiol,2008,141:
5、173-carcinomaantigen.Cancer,2000,88:2298-2304.178.@@[14]LaiPF,HsiehSC,ChienJ,etal.Malignanttransformationofan@@[4]HackethalA,BrueggnannD,BohlmannMK,etal.Squamousovarianmaturecysticteratoma:computedtomographyfindings.cellcarcinomainmaturecysticteratomaoftheovary:system
6、aticArchGynecolObstet,2005,271:355-357.reviewandanalysisofpublisheddata.LancetOncol,2008,9:@@[15]ZissinR.CTdiagnosisofmalignantdegenerationofanovarian1173-1180.teratoma.GynecolOncol,2000,77:482.@@[5]YahataT,KawasakiT,SerikawaT,etal.Adenocarcinoma@@[16]TakemoriM,Nishim
7、uraR.MRIfindingsofanovariandermoidarisingfromrespiratoryciliatedepitheliuminbenigncysticcystwithmalignanttransformation.MagnResonMedSci,2003,teratomaoftheovary:acasereportwithanalyzesoftheCT,MRI,2:105-108.andpathologicalfindings.JObstetGynaecolRes,2008,34:408-@@[17]Ki
8、kkawaF,IshikawaH,TamakoshiK,etal.Squamouscell412.carcinomaarisingfrommaturecysticteratomaoftheovary:a@@[6]SongYJ,RyuSY,ChoiS
