Elevated carbohydrate antigen 19‐9 in a dermoid cyst
Elevated carbohydrate antigen 19‐9 in a dermoid cyst
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皮样囊肿中碳水化合物抗原 19-9 升高
DOI：
10.1016/j.ijgo.2005.07.019
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发表时间：
2005
影响因子：
3.8
通讯作者：
S. Tezcan
中科院分区：
文献类型：
--
作者：
C. Atabekoğlu;E. A. Bozacı;S. Tezcan
一位25岁的处女女性被转介到这个诊所，因为一个非常大的和复杂的右侧卵巢囊肿发现腹部超声。腹部骨盆超音波及电脑断层检查发现一个分叶状囊状病灶，长约30公分，内含不均匀实性结构及乳头状突起。左侧卵巢和其他腹腔内结构正常。血清CA 19-9水平为1430 U/mL，CA 125水平为46.6 U/mL。其他肿瘤标志物均在正常范围内。通过影像学和内窥镜检查排除了任何胃肠道系统疾病。行右侧输卵管卵巢切除术，冰冻切片的组织病理学评价确定病变为皮样囊肿。多个囊肿部位的多个切片未显示任何恶性病灶。一些囊腔衬有单层粘液上皮，呼吸道粘膜表达CA 19-9的弥漫性和强细胞质阳性（图1）。因此，成熟畸胎瘤本身经化学鉴定为CA-19-9的来源。术后，CA 19-9和CA 125水平恢复正常。在1%的皮样囊肿中，一个组织成分显示恶性转化，最常见的是鳞状细胞癌。血清CA 125和CA 19-9水平升高似乎与恶性转化无关[1]。在一些卵巢皮样囊肿和许多其他部位的皮样囊肿中，CA 19-9水平升高已被报道[2-5]，但本研究可能是在英文文献中报道的与卵巢或任何其他部位的皮样囊肿相关的最高血清CA 19-9水平。免疫组化显示，CA 19-9染色在顶端细胞上显著，
A 25-year-old virgin woman was referred to this clinic because of a very large and complicated right ovarian cyst detected by abdominal ultrasonography. Abdominopelvic ultrasonography and computerized tomography revealed a lobulated cystic lesion measuring 30 cm and containing heterogeneous solid structures as well as papillary projections. The left ovary and other intra-abdominal structures were normal. Serum CA 19-9 level was 1430 U/mL and CA 125 level was 46.6 U/mL. Other tumor markers were in normal ranges. Any gastrointestinal system disease was ruled out by imaging and endoscopic procedures. Right salpingo-oophorectomy was performed, and a histopathologic evaluation of a frozen section determined the lesion to be a dermoid cyst. Multiple sections from various cyst sites did not reveal any malignant foci. Some cystic cavities were lined with simple mucinous epithelium, and with respiratory mucosa that expressed diffuse and strong cytoplasmic positivity for CA 19-9 (Fig. 1). Therefore, the mature teratoma itself was identified immunohistochemically as the source of CA-19-9. Postoperatively, CA 19-9 and CA 125 levels returned to normal.In 1% of dermoid cysts, one tissue element shows malignant transformation, most often to squamous cell carcinoma. Elevated serum CA 125 and CA 19-9 levels seem unrelated to malignant transformation [1]. Increased CA 19-9 levels in some dermoid ovarian cysts and dermoid cysts in many other locations have been reported [2—5], but the present study is probably reporting the highest serum level of CA 19-9 in association with a dermoid cyst—of the ovary or any other location—in English literature. Immunohistochemically, CA 19-9 staining was prominent on the apical cyto-