卵巢原发混合性生殖细胞瘤1例并文献复习.docVIP

卵巢原发混合性生殖细胞瘤1例并文献复习 　　[摘要] 卵巢混合性生殖细胞瘤是一种较为罕见的高度恶性肿瘤，其进展较快，预后较差。我们通过对1例20岁年轻女性病例进行临床资料分析并复习文献，以加深对该瘤的认识。结果发现该肿瘤由两种成分混合存在，一种是典型的卵黄囊瘤，一种是无性细胞瘤。混合性生殖细胞瘤是卵巢生殖源性肿瘤中最常见的类型，镜下肿瘤由两种或两种以上的生殖细胞组成，免疫组化对诊断及鉴别诊断有重要作用，其生物学行为和预后与其组织学类型有关。 　　[关键词] 卵巢；混合性；生殖细胞；卵黄囊瘤；无性细胞瘤 　　[中图分类号] R737.31 [文献标识码] B [文章编号] 1673-9701（2015）30-0122-02 　　A case report of ovarian primary mixed germ cell tumor and review of the literature 　　LI Wei1 WENG Libin2 YUAN Xiaolu3 WEI Jianguo4 　　1.Department of Gynaecology and Obstetrics， Ningbo Yinzhou Peoples Hospital， Ningbo 315040， China； 2.Department of Internal Medicine， Ningbo Yinzhou Sixth Hospital， Ningbo 315040， China； 3.Department of Pathology， Xiaogan Central Hospital of Hubei Province， Xiaogan 432100， China； 4.Department of Pathology， Shaoxing Peoples Hospital of Zhejiang Province， Shaoxing 312000， China 　　[Abstract] Ovarian primary mixed germ cell tumor is a rarely kind of highly malignant tumor. Because of rapid progression，its prognosis is poor. By means of analyzing the clinical data of 20-year-old female case and review of the literature，we could deeply understanding this kind of tumor. The results showed that the tumor was consisted of two components， one was the typical yolk sac tumor， the other was dysgerminoma. Mixed germ cell tumor was the most common ovarian reproductive source tumour types. The tumor is composed of two or over two kinds of germ cell tumos. Immunohistochemistry plays an important role in the diagnosis and differential diagnosis of ovarian mixed germ cell tumor. Its biological behavior and prognosis depend on combined different histological types. 　　[Key words] Ovarian； Mixed； Germ cell； Yolk sac tumor； Dysgeminoma 　　发生于卵巢的混合性生殖细胞肿瘤（mixed germ cell tumor，MGCT）比较少见，是卵巢生殖源性肿瘤中最常见的类型，由于多是年轻人发病，且症状隐匿，临床上容易误诊及漏诊，错过最佳治疗时机。目前国内报道不多。本文报道1例原发于卵巢的混合性生殖细胞瘤，并结合文献复习，以加深对该瘤的认识。 　　1 临床资料 　　患者女，20岁，尿频5个月，B超发现盆腔肿块3 d于2012年6月24日入院。5个月前无明显诱因下出现尿频，无尿急、尿痛，偶有下腹痛、腰背酸痛，自行缓解，无阴道出血，无恶心呕吐，无腹胀腹泻，无大便异常。B超示盆腔内肿块（增大子宫伴宫内回声不均质团块填充可能），正常子宫形态结构消失，