Mature Cystic Teratoma: A Clinicopathologic Evaluation of 517 Cases and Review of the Literature
Mature Cystic Teratoma: A Clinicopathologic Evaluation of 517 Cases and Review of the Literature
复制标题
成熟囊性畸胎瘤517例临床病理评价及文献复习
作者：
J. Comerci;F. Licciardi;P. Bergh;C. Gregori;J. Breen
目的探讨成熟囊性畸胎瘤的临床病理表现及治疗趋势。方法对1975年1月1日至1989年12月31日的肿瘤登记资料和病历资料进行分析，包括患者年龄、肿瘤大小、双侧性、恶性转化和治疗情况。结果517例患者共切除573个肿瘤。中位年龄为30岁，平均年龄（±标准差）为32±11.3岁。310例（60%）患者无症状。肿瘤平均大小6.4±3.5 cm。双边率为10.8%。扭转率为3.5%；较大的肿瘤发生扭转的频率高于较小的肿瘤（P = 0.029）。恶性转化率为0.17%。膀胱切除术患者的平均囊肿直径为5.7±2.4 cm；卵巢切除术：8.0±4.1 cm；子宫切除术为6.1±3.8 cm。与膀胱切除术相比，更大的肿瘤行卵巢切除术（P = 0.01）。在整个研究期间，子宫切除术的数量保持稳定，而卵巢切除术的数量明显减少，膀胱切除术的数量明显增加。对侧卵巢活检在研究早期很常见（48.5%）。到1989年，活检率不到1%。结论：我们发现有症状的肿瘤、扭转和恶性变性的患病率比大多数其他研究者之前报道的要低。此外，在过去的14年里，这些肿瘤的治疗发生了重要的变化，卵巢保存的趋势增加，这可以从更频繁地使用膀胱切除术和对侧卵巢活检的减少中得到证明。
Objective To evaluate the clinical and pathologic presentation of mature cystic teratomas and the trends in management over a 14-year study period. Methods Tumor registry data and medical records between January 1, 1975 and December 31, 1989 were analyzed with respect to patient age, tumor size, bilaterality, malignant transformation, and treatment. Results Five hundred seventy-three tumors were removed from 517 patients. The median and mean (± standard deviation) age was found to be 30 and 32 ± 11.3 years, respectively. Three hundred ten (60%) of the patients were asymptomatic. The mean tumor size was 6.4 ± 3.5 cm. The bilaterality rate was 10.8%. The rate of torsion was 3.5%; larger tumors underwent torsion more frequently than smaller tumors (P = .029). The rate of malignant transformation was 0.17%. The mean cyst diameter for patients undergoing cystectomy was 5.7 ± 2.4 cm; for oophorectomy, 8.0 ± 4.1 cm; and for hysterectomy, 6.1 ± 3.8 cm. Oophorectomies were performed for larger tumors when compared to cystectomies (P = .01). The number of hysterectomies was stable throughout the study period, whereas the number of oophorectomies decreased and the number of cystectomies increased markedly. Contralateral ovarian biopsy was common (48.5%) early in the study period. By 1989, the biopsy rate was less than 1%. Conclusions We found the prevalence rates of symptomatic tumors, torsion, and malignant degeneration to be less than those previously reported by most other investigators. In addition, there has been an important change over the past 14 years in the management of these neoplasms, with an increased tendency for ovarian preservation, as evidenced by the more frequent use of cystectomy and a decrease in contralateral ovarian biopsy.