Tumor-to-tumor metastasis from appendiceal adenocarcinoma to an ovarian mature teratoma, mimicking malignant transformation of a teratoma: a case report
Tumor-to-tumor metastasis from appendiceal adenocarcinoma to an ovarian mature teratoma, mimicking malignant transformation of a teratoma: a case report
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DOI：
10.1186/s13000-019-0865-6
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发表时间：
2019-08-14
影响因子：
2.6
通讯作者：
Yasuda, Masanori
中科院分区：
文献类型：
--
作者：
Yano, Mitsutake;Katoh, Tomomi;Yasuda, Masanori
肿瘤到肿瘤转移（TTM）是一种罕见但文献充分的现象，它被定义为组织学上不同的肿瘤的转移。卵巢成熟畸胎瘤（OMTs）可以通过恶性转化与各种癌症共存，这可能使其难以与TTM区分。在此，我们报告一例从阑尾腺癌到OMT的TTM，模拟OMT的恶性转化。一例67岁日本妇女因卵巢肿瘤在另一家医院行腹部全子宫切除术和双侧输卵管卵巢切除术。她最初被诊断为粘膜癌/类癌。手术后一年，她在阑尾肿块增加后被转介到我们医院。针对阑尾肿瘤的盲肠活检显示散在的黏液细胞具有印戒特征，其形态与先前诊断的右侧OMT的恶性成分相似。阑尾腺癌和OMT的恶性成分CK7、CK20、CDX-2和SATB2均呈阳性，但雌激素受体、孕激素受体和pax-8均呈阴性。最后，我们确认了阑尾杯状细胞类癌转移到右侧OMT的诊断。患者在初次手术后接受了35个月的全身化疗，存活了肿瘤。结论当发现异常恶性肿瘤时，认识TTM现象对避免错误诊断和选择适当治疗具有重要意义。
Background Tumor-to-tumor metastasis (TTM) is a rare but well-documented phenomenon that is defined as metastasis in a histologically distinct tumor. Ovarian mature teratomas (OMTs) can coexist with various cancers by malignant transformation, which may make it difficult to distinguish these from TTM. Herein, we report a case of TTM from appendiceal adenocarcinoma to the OMT, mimicking the malignant transformation of OMT. Case presentation A 67-year-old Japanese woman underwent abdominal total hysterectomy and bilateral salpingo-oophorectomy for an ovarian tumor in another hospital. She was initially diagnosed with mucinous carcinoma/carcinoid arising in the OMT. One year after surgery, she was referred to our hospital after the presentation of increased appendiceal mass. Cecal biopsy targeting an appendiceal tumor revealed scattered mucinous cells with signet ring features, which were morphologically similar to the malignant components in the previously diagnosed right OMT. Both the appendiceal adenocarcinoma and malignant components of the OMT stained positive for CK7, CK20, CDX-2, and SATB2 but negative for estrogen receptor, progesterone receptor, and pax-8. Finally, we confirmed the diagnosis of appendiceal goblet cell carcinoid metastasizing to the right OMT. The patient had tumor-bearing survival due to systemic chemotherapy administered for 35 months after the initial surgery. Conclusions Awareness of the TTM phenomenon is important to avoid an incorrect diagnosis and to select the appropriate therapy when unusual malignancy is encountered in the OMTs.