卵巢原发性恶性黑色素瘤1例及文献复习
作者：赵鲁笳 钟定荣 刘天卿 邢广莹 候晓春
单位：赵鲁笳 刘天卿 邢广莹 候晓春(大连市友谊医院病理科 116001)；钟定荣(解放军总医院病理科)
关键词：卵巢；恶性黑色素瘤；成熟性囊性畸胎瘤；免疫组织化学；鉴别诊断
诊断病理学杂志000109摘 要：目的 探讨卵巢原发性恶性黑色素瘤的临床病理特征，及其与卵巢转移性肿瘤的鉴别诊断。方法 对1例原发于卵巢囊性畸胎瘤的恶性黑色素瘤标本，通过光镜及免疫组化等方法进行病理组织学观察。结果 组织学特征为：肿瘤细胞大小不等，形态多样，界限不清，呈透明细胞和/或印戒细胞样；瘤细胞内外可见一些粗大的黑色素颗粒，瘤组织内血管较多，核分裂象多见，>10个HPF。免疫组化HMB45、Vimentin及S-100蛋白肿瘤细胞呈阳性表达。结论 卵巢原发性恶性黑色素瘤来源于卵巢成熟的囊性畸胎瘤恶变，是一种罕见的卵巢肿瘤。根据其组织学和病理形态学特征，结合腹部包块和囊性畸胎瘤等临床表现，可以作出明确的病理诊断。
, http://www.100md.com
分类号：R737.31 文献标识码：A
文章编号：1007-8096(2000)01-0024-03
Primary malignant melanoma of ovary—A case report and literature review
Zhao Lujia,Zhong Dingrong,Liu Tianqing
(Department of Pathology, DaLian Friendship Hospital, DaLian 116001)
Abstract：Objective To study the clinical pathological characteristics of primary ovarian malignant melanoma and its differen-tial diagnosis from metastatic tumors of ovary. Methods A case of primary malignant melanoma arising from a cystic teratoma of the ovary was studied by histopathologcal observation and immunohistochemical staining. Results The histological characteris-tics of the tumor are that the tumor cells vary in size and shape and have vague boundary, and showed clear cytoplasm and/or signet-ring morphology.Some thick melanin grains can be seen in or out of the cells, Numerous blood vesels and mitotic figures(>10/10HPF) are present Immunohistochemical stainings of HMB45, vimentin and S-100 protein are positive in the tumor cells. Conclusions Primary ovarian malignant melanoma arising from a mature cystic teratoma with malignant change, was a rare neoplasm. Based on the histopathological characteristics and clinical manifestations a definite pathological diagnosis of the tu-mor can be made.
, 百拇医药
Keywords：Ovary malignant melanoma Mature cystic teratoma Immunohistochemistery Differential diagnosis
参考文献：
[1]Amann JA.Promares melanesarkom des ovariums(Abstr).Zentralbl Gy-nakol,1903,27:213
[2]张品南,朱丽华,双侧卵巢原发性恶性黑色素瘤伴麦格氏综合征1例.浙江医学,1984,6:46.
[3]王肇敏.887例卵巢畸胎瘤的回顾总结.天津医药,1980,3:136.
[4]Boughton RS,Hughmanick S,Maiin-Padilla,M.Malignant melanoma aris-ing in an ovarian cystic teratoma in pregnancy.J Am Acad Dermatol,1987,17:871-75
, 百拇医药
[5]Morrow CP,Disaia PJ. Malignant melanoma of the female genitalia: A clinical analysis.Obstet Gynecol surv, 1976,31:233-716
[6]Cronje HS,Woodruff JD.Primary ovarian malignant melanoma arising in cystic teratoma.Gynecol Oncol,1981,12:379-83
[7]Ueda Y,Kimura A,Kawahara E,et al.Malignant melanoma arising in a dermoid cyst of the ovary,cancer,1991,67:3141-5
[8]Scully RE.Tumor of the ovary and maldeveloped gonads.In: Atlas of tu-mor pathology Fascicle 16 series 2.Washington DC:Armed Forces Insti-tute of Pathology,1979.344
, 百拇医药
[9]Martinelli G,Tapparelli E,Merz R,et al.Case of bilateral ovarian metas-tasis from regressed melanoma.Eur J Gynaecol Oncol,1984,5:150-3
[10]Carlson JR,Wheeler JE.Primary ovarian melanoma arising in a dermoid stage Ⅲ c: Lang-term disease-free survival with aggressive surgery and platinum therapy.Gynecol Oncol,1993,48:397-401
收稿日期：1999-04-09
修稿日期：1999-05-08, 百拇医药
单位：赵鲁笳 刘天卿 邢广莹 候晓春(大连市友谊医院病理科 116001)；钟定荣(解放军总医院病理科)
关键词：卵巢；恶性黑色素瘤；成熟性囊性畸胎瘤；免疫组织化学；鉴别诊断
诊断病理学杂志000109摘 要：目的 探讨卵巢原发性恶性黑色素瘤的临床病理特征，及其与卵巢转移性肿瘤的鉴别诊断。方法 对1例原发于卵巢囊性畸胎瘤的恶性黑色素瘤标本，通过光镜及免疫组化等方法进行病理组织学观察。结果 组织学特征为：肿瘤细胞大小不等，形态多样，界限不清，呈透明细胞和/或印戒细胞样；瘤细胞内外可见一些粗大的黑色素颗粒，瘤组织内血管较多，核分裂象多见，>10个HPF。免疫组化HMB45、Vimentin及S-100蛋白肿瘤细胞呈阳性表达。结论 卵巢原发性恶性黑色素瘤来源于卵巢成熟的囊性畸胎瘤恶变，是一种罕见的卵巢肿瘤。根据其组织学和病理形态学特征，结合腹部包块和囊性畸胎瘤等临床表现，可以作出明确的病理诊断。
, http://www.100md.com
分类号：R737.31 文献标识码：A
文章编号：1007-8096(2000)01-0024-03
Primary malignant melanoma of ovary—A case report and literature review
Zhao Lujia,Zhong Dingrong,Liu Tianqing
(Department of Pathology, DaLian Friendship Hospital, DaLian 116001)
Abstract：Objective To study the clinical pathological characteristics of primary ovarian malignant melanoma and its differen-tial diagnosis from metastatic tumors of ovary. Methods A case of primary malignant melanoma arising from a cystic teratoma of the ovary was studied by histopathologcal observation and immunohistochemical staining. Results The histological characteris-tics of the tumor are that the tumor cells vary in size and shape and have vague boundary, and showed clear cytoplasm and/or signet-ring morphology.Some thick melanin grains can be seen in or out of the cells, Numerous blood vesels and mitotic figures(>10/10HPF) are present Immunohistochemical stainings of HMB45, vimentin and S-100 protein are positive in the tumor cells. Conclusions Primary ovarian malignant melanoma arising from a mature cystic teratoma with malignant change, was a rare neoplasm. Based on the histopathological characteristics and clinical manifestations a definite pathological diagnosis of the tu-mor can be made.
, 百拇医药
Keywords：Ovary malignant melanoma Mature cystic teratoma Immunohistochemistery Differential diagnosis
参考文献：
[1]Amann JA.Promares melanesarkom des ovariums(Abstr).Zentralbl Gy-nakol,1903,27:213
[2]张品南,朱丽华,双侧卵巢原发性恶性黑色素瘤伴麦格氏综合征1例.浙江医学,1984,6:46.
[3]王肇敏.887例卵巢畸胎瘤的回顾总结.天津医药,1980,3:136.
[4]Boughton RS,Hughmanick S,Maiin-Padilla,M.Malignant melanoma aris-ing in an ovarian cystic teratoma in pregnancy.J Am Acad Dermatol,1987,17:871-75
, 百拇医药
[5]Morrow CP,Disaia PJ. Malignant melanoma of the female genitalia: A clinical analysis.Obstet Gynecol surv, 1976,31:233-716
[6]Cronje HS,Woodruff JD.Primary ovarian malignant melanoma arising in cystic teratoma.Gynecol Oncol,1981,12:379-83
[7]Ueda Y,Kimura A,Kawahara E,et al.Malignant melanoma arising in a dermoid cyst of the ovary,cancer,1991,67:3141-5
[8]Scully RE.Tumor of the ovary and maldeveloped gonads.In: Atlas of tu-mor pathology Fascicle 16 series 2.Washington DC:Armed Forces Insti-tute of Pathology,1979.344
, 百拇医药
[9]Martinelli G,Tapparelli E,Merz R,et al.Case of bilateral ovarian metas-tasis from regressed melanoma.Eur J Gynaecol Oncol,1984,5:150-3
[10]Carlson JR,Wheeler JE.Primary ovarian melanoma arising in a dermoid stage Ⅲ c: Lang-term disease-free survival with aggressive surgery and platinum therapy.Gynecol Oncol,1993,48:397-401
收稿日期：1999-04-09
修稿日期：1999-05-08, 百拇医药