CAJ | 학술논문

背景与目的：卵巢甲状腺肿是一种少见肿瘤，尤其伴有卵巢外播散的更为少见。本研究旨在探讨卵巢甲状腺肿的临床及病理组织学特征、诊断及鉴别诊断。方法：观察14例良、恶性卵巢甲状腺肿的临床及病理学特征，行免疫组化EnVision法染色，PCR-DNA检测，同时复习相关文献。结果：14例良、恶性卵巢甲状腺肿患者平均年龄45.6岁(18~71岁)，以盆腔肿物为主要临床表现。其中12例为卵巢甲状腺肿，镜下主要由增生的甲状腺组织构成；1例为恶性卵巢甲状腺肿，镜下呈甲状腺乳头状癌表现；1例来源于卵巢甲状腺肿的高分化滤泡癌(highly differentiated follicular carcinoma of ovarian origin，HDFCO)，镜下组织学呈良性但生物学呈恶性表现。结论：卵巢甲状腺肿是少见的单胚层畸胎瘤，恶变率低，尤其是超出卵巢病变已有播散而镜下组织学呈良性的卵巢甲状腺肿发病率更低，具有较独特的临床病理学特征。良、恶性卵巢甲状腺肿预后均较好，需与颗粒细胞瘤、类癌鉴别。
배경여목적：란소갑상선종시일충소견종류，우기반유란소외파산적경위소견。본연구지재탐토란소갑상선종적림상급병리조직학특정、진단급감별진단。방법：관찰14례량、악성란소갑상선종적림상급병이학특정，행면역조화EnVision법염색，PCR-DNA검측，동시복습상관문헌。결과：14례량、악성란소갑상선종환자평균년령45.6세(18~71세)，이분강종물위주요림상표현。기중12례위란소갑상선종，경하주요유증생적갑상선조직구성；1례위악성란소갑상선종，경하정갑상선유두상암표현；1례래원우란소갑상선종적고분화려포암(highly differentiated follicular carcinoma of ovarian origin，HDFCO)，경하조직학정량성단생물학정악성표현。결론：란소갑상선종시소견적단배층기태류，악변솔저，우기시초출란소병변이유파산이경하조직학정량성적란소갑상선종발병솔경저，구유교독특적림상병이학특정。량、악성란소갑상선종예후균교호，수여과립세포류、유암감별。
Background and purpose:Struma ovarii is a rare tumor, especially with extraovarian spreading. The study aimed to investigate the clinical and pathological features, diagnosis and differential diagnosis of ovarian goiter. Methods:Clinical and pathological features of 14 cases of benign and malignant ovarian goiter were observed. Immunohistochemical EnVision staining, PCR-DNA sequencing and review of related literature were also used. Results:In 14 cases of benign and malignant ovarian goiter, the average age of onset is 45.6 years (18-71 years old), and pelvic tumor is the main clinical manifestation. According to the related literature of diagnostic criteria, 12 cases are struma ovarii, which is consisted of hyperplasia of the thyroid tissue under microscopic examination, 1 case is malignant struma ovarii, which is papillary thyroid carcinoma by microscopic presentation, and 1 case is highly differentiated follicular carcinoma of ovarian origin (HDFCO), which is histological benign by microscopic presentation, but is malignant by biological behavior. Conclusion:Struma ovarii is a rare ovarian mondemal teratoma, with low rate of malignant change and beyond ovarian lesions disseminated microscopic histological benign struma ovarii is lower incidence, which has unique clinical and pathological features. Comprehensively considering the related literatures, this study indicates that the disease is in accordance with HDFCO. Struma ovarii prognosis is good, and should be differentiated from carcinoid and granular cell tumor.