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卵巢囊狀畸胎瘤合併良性皮脂腺瘤一罕見病例報告
Cystic Teratoma of Ovary with Sebaceous Adenoma: A Rare Case Report
摘要
文獻報告卵巢畸胎瘤合併良性皮脂腺瘤非常罕見。迄今在歐美文獻中僅有3例報告，其發生原因不明，腫瘤組織結構與皮膚之皮脂腺瘤十分類似。本文特別報告一例52歲已婚女性，因骨盆腔腫瘤，接受子宮與兩倒輸卵管和卵巢切除術。手術發現左側卵巢有一個重達480公克囊狀腫瘤，囊內瀦積皮脂性物質，束狀毛髮，2顆牙齒。此外另有一從囊內壁向囊內凸起，大小為5X4X2公兮的黃色實體腫瘤，鏡檢發現主要由排列葉狀的熟悉皮脂細胞和不成熟皮脂細胞組成，偶見有絲分裂。以PAP免疫組織化學染色法測試，發現僅角質化腫瘤細胞對細胞角質素呈強烈陽性免疫反應。僅少數成熟皮脂細胞對癌胚胎抗原，呈陽性免疫反應。病理組織診斷為卵巢囊狀畸胎瘤合併良性皮脂腺瘤。目前病患接受手術後門診追蹤已逾9個月，無局部復發或遠側轉移跡象。
並列摘要
Teratoma of ovary with sebaceous adenoma is a very rare disease. Up to date, only 3 cases had been reported in English literature. The etology is not clear and the histological pattern is similar to the sebaceous adenoma of skin. The prognosìs is very good after salpingo-oophorectomy. Herein, we port a case of cystic teratoma of left ovary. A 52-year-old married woman who was subsequently received total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH & BSO). The cystic teratoma was unilocular, weighed 480 gm., and contained turbid brown fluid sebaceous material, a few hair shafts and two teeth. A intramural mass (5x4x2cm. in size) composed of lobules of mature and immature sebaceous tumor cells was identified on the inner surface of the cystic wall. The immunohistochemical peroxidase-antiperoxidase (PAP) assay showed keratinzed tumor cells expressed strong positive immunostains to cytokeratin (56KD) and only a faw mature sebaceous tumor cells expressed carcinoembryonic antigen (CEA). The patient has been closely followed up at OPD for 9 months without evidence of local recurrence or distant metastases.