3.5%
,
, , , ,
.1
.
1% ,2
. .
2 85%
.1 ,
. 1
.
, 71 , (4-0-0-4) 2002 8
2002 10 .
71 2002 8
2002
9 10 3 kg
2002 10 (
)
, 8×5×4 cm
.
Department of Obstetrics and Gynecology, Kosin University College of Medicine, Busan, Korea
The malignant mixed Mesodermal (Müllerian) tumor (MMMT) is an uncommon tumor containing epithelial and mesenchymal components. MMMT of the ovary is rare, constituting less than 1% of all primary ovarian tumors. Most of all were heterologous type and 80% occur in postmenopausal women. It is a particularly aggressive and rapidly progressive tumor, especially in advanced stages. MMMT is highly malignant and the prognosis is poor due to frequent metastasis and recurrence. This disease is usually advanced when diagnosed, because it is asymptomatic in early stage.
The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment for this neoplasm is still controversial because of its rarity.
We experienced one case of malignant mixed mesodermal tumor of the ovary and report with brief review of literature.
Key Words : Malignant mixed mesodermal tumor, Ovary
.
, 7×4 cm
6×4 cm 5×7.4×12.9 cm
carcinomatous with pseudosarcomatous differentiation
. 2000
. 2000 3 ciment .
. 14
5~7 , , ,
52 .
, ,
120/70, 64 / , 36.6 ,
,
. 7×5 cm
, . ,
.
14.1 gm/dl, 39.7% 5400/mm3 (
57.8%, 33.0%) , ,
, X
. CEA 1.6 ng/ml, CA
19-9 12.0 U/ml, AFP 6.474 ng/ml ,
CA-125 155 U/ml .
6×4 cm ,
. . 7×4 cm
.
. 2
.
. .
(Fig. 1).
,
,
. loop
, 10×8 cm
. ,
, .
,
, ,
, , ,
.
, , ,
3
, 8×5×4 cm .
. ,
.
. 5×8×2.5 cm , 40 gm
.
. ,
10×8 cm
, loop .
1 cm .
, ,
.
. .
, ,
, .
, , , , S ,
, ,
.
cytokeratin, progesterone receptor ,
vimentin , p53, EMA
, c-kit , actin, desmin,
S-100 protein (Fig. 2, Fig.
3, Fig. 4).
, 19 paclitaxel 216 mg/m2, carboplatin 480 mg/
m2 1 4 . 2
CA-125 51.1 , 4
CA-125 75.5 .
CA-125 .
1854 Wagner , 1864 Virchow
(carcinosarcoma) .
,
(malignant mixed
mesodermal tumor) .
,
1% .3 1950
, .
,
, , ,
.
, 1/3 .
.2 (coelomic
epithelium) (multipotent cell) . Takeda 4
, (stem cell) .
60~70
, Hanjani 5 66 ,
Dictor 63.4 , Annette
(83%) .7
71 .
.6
.
.
, , ,
, 92%
64% .1
, CA-125
,8 CA-125 155 U/ml
. CA-125
CA-125 .8
,
, 10-16 cm ,
30 cm .5
, 10%
.9
.
, ,
.5 ,
.11 ,
.10
, ,
,
, .
cytokeratin progesterone receptor
, vimentin
.
p53 , EMA
. Keith 11
PAS (periodic acid-Schiff) -antitrypsin diastase-resistance hyaline droplet
. actin
, rhabdomyosarcoma
myosin myoglobulin .
FIGO
, .
Hanjani 4 64.7% Annette 6 70%
. ,
, .12
,
, , , ,
c .
, I
. . .
.13
8~16 ,
1 70% .14
Muntz
,
, ,
.15
, .
,
, 27% 100% .
13,16-18 platinum-based 1 50%
,17,18 platinum-based ifosfamide paclitaxel
.19 Sit 19 ifosfamide cisplatin
23 , Sutton 18
ifosfamide cisplatin .
paclitaxel cisplatin, paclitaxel carboplatin
.19 paclitaxel carboplatin .
, ,
.
,
, , ,
.
71 1
.
.
, 1% . , 80%
60-70 .
stage .
,
8~16 .
1 .
,
