畸胎瘤的惡性轉變

成熟性囊狀畸胎瘤是生育年齡婦女中最常見的一種良性的卵巢生殖細胞腫瘤，其約略有百分之十至十五雙側存在。雖然畸胎瘤絕大部份為良性的，但其合併惡性變化的機會大約為1-3%。畸胎瘤的惡性變化以鱗狀上皮癌(squamous cell carcinoma)最為常見，約為70-88%。畸胎瘤會發生惡性的變化其危險性與病患的年齡有關，所以在停經後的婦女，一但發現有畸胎瘤時要高度懷疑有惡性變化的可能性。不過年輕人也不能排除惡性變化的可能。手術前的詳加檢查，配合一些影像學及腫瘤標記，如SCC、AFP，或許可提供一些參考。手術的選擇，包括腹腔鏡手術及閉腹手術的好處與限制，以及避免術中腫瘤的破裂、沾粘及早期發現惡性變化，均對此疾病的治療非常重要。本文就是針對成熱性囊狀畸胎瘤的惡性變化作一個簡單的介紹，讓讀者對此疾病有初步的瞭解。

關鍵字

惡性變化；成熟性囊狀畸胎瘤；卵巢；鱗狀上皮癌

並列摘要

Mature cystic teratomas (MCT), commonly called dermoid cysts, are the most common benign germ cell tumors of the ovary in women of reproductive age. MCT involving both ovaries is 10~15%. 1-3% of MCT will show malignant transformation and its risk is dependent on the age of diagnosis with more advanced age with higher risk. Among the cases of transformation, squamous cell carcinoma is most common type accounting for 70~88%. Careful preoperative evaluation, including imaging, tumor markers (SCC and AFP) will assist diagnosis. Patients requiring surgery should be appropriately counseled about the risks and benefits of laparoscopy and laparotomy, the risks of intraoperative MCT spillage, adhesion formation, and malignant transformation. The goal of this article is to review these issues arid provide the physician with the information to counsel their patients preoperatively.

並列關鍵字

malignant transformation ； mature cystic teratoma ； ovary ； squamous cell carcinoma

國際替代計量

畸胎瘤的惡性轉變

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