ovarian clear cell tumor
Introduction
Introduction to ovarian clear cell tumor An ovarian clear cell tumor refers to a tumor from the Miller tube epithelium, histologically found in the vagina, cervix, endometrium, and broad ligament. Tumors can be divided into benign, borderline and malignant, benign and rare, and borderline is rare. Ovarian clear cell carcinoma accounts for 5% to 11% of ovarian epithelial cancer. The average age of onset was 48 to 58 years old, more common in 45 years old and older, and the patients were all older than 25 years old. The clinical manifestations were asymptomatic in the early stage, and the edema and appetite decreased in the late stage, and CA125 and CA199 increased. Treatment is based on surgery and chemotherapy. basic knowledge Sickness ratio: 0.0001% Susceptible people: women Mode of infection: non-infectious Complications: endometriosis
Cause
Ovarian clear cell tumor etiology
Malignant (30%):
Mostly cystic, tough, varying in size, unilateral, bilateral up to 24%, cut surface is fish-like, or light yellow, often accompanied by bleeding, necrosis, careful examination can often be found with endometrium Ectopic, visible transparent cells, spike cells and eosinophils, the nucleus of the nucleus, visible mitotic figures, more than the borderline).
Borderline (30%):
Tumors vary in size and are lobulated, solid or solid with small sac formation. A small number of borderline clear cell tumors have been diagnosed as adenofibroma, and other clear cell adenomas (clearcell adenoma) And cystic adenoma (cystadenofibroma), the epithelium of the tumor cell nest is composed of 1-3 layers of polygonal cells or spike-shaped cells, atypical cells can be seen, mitosis is like no more than 3 per 10 high-powered fields, interstitial No infiltration.
Benign (25%):
It consists of clear cells and a hobnail cell lined with fibroid-like tissue.
Prevention
Ovarian clear cell tumor prevention
Epidemiology: Ovarian clear cell tumors account for 5% to 11% of ovarian epithelial cancer, and 15% have been reported. The average age of onset is 48 to 58 years old, but it is more than 45 years old. Almost all cases are older than 25 years old. Benignity in ovarian clear cell tumors is extremely rare and borderline is rare.
Prognosis: Although the diagnosis is mostly early, the recurrence rate is higher than other epithelial cancers, and the prognosis is worse than serous cancer. However, the prognosis of benign and borderline surgery is better.
health care:
1. Within 6 hours after surgery, the supine position of the pillow is used, and the head is sideways to prevent the vomit from inhaling the trachea.
Second, because most patients have no pain after surgery, do not ignore the waist and legs of the patient, and turn over once every half hour to promote blood circulation and prevent hemorrhoids.
Third, the liquid can be removed on the same day, and the urinary catheter can be removed to encourage the patient to get out of bed.
Fourth, 6 hours after surgery, you can enter a small amount of liquid diet, such as rice soup, noodle soup. Do not drink sugary drinks such as sweet milk or soy milk powder.
Fifth, the laparoscopic incision is only 1 cm, so the abdominal dressing can be removed after a week, and can be showered, and then gradually resume normal activities. It is necessary to pay attention to proper and light activities a week ago to restore the body as soon as possible.
Complication
Ovarian clear cell tumor complications Complications endometriosis
Causes precocious puberty, can occur tumor and pedicle torsion, bleeding and necrosis, can cause urination and difficulty in defecation, etc., can also be complicated by pelvic endometriosis. Due to the oppression of ovarian tumors, mild oppression can enhance the endocrine function of the ovary, which is an increase in the secretion of estrogen and progesterone. Severe oppression can cause the ovaries to shrink and function decline. When the pedicle is reversed, it will cause severe pain in the abdomen, which is an acute abdomen of gynecology.
Symptom
Ovarian clear cell tumor symptoms Common symptoms Powerless abdominal mass bloating appetite loss ovarian hairy polyuria endometriosis ectopic menopausal postmenopausal bleeding polydipsia polydipsia
Often due to abdominal mass, abdominal distension and treatment, half of the patients have a history of infertility, menstrual disorders or postmenopausal bleeding, about 10% with hypercalcemia, the typical symptoms are loss of appetite, muscle weakness, polyuria, polydipsia, etc., surgery After resection of the tumor, hypercalcemia usually returns to normal within 36 hours. If the tumor recurs, the blood calcium rises again, and the clear cell carcinoma is closely related to endometriosis. The pelvic endometriosis can be as high as 25%. ~50%, higher than all other ovarian cancers including ovarian endometrioid carcinoma, ovarian clear cell carcinoma often due to large tumors, most of the early diagnosis, can be as high as 50% to 65%, which is different from other ovaries Epithelial cancer.
Examine
Examination of ovarian clear cell tumors
First, laboratory inspection:
1, electrolyte detection: serum calcium and so on.
2, tumor marker examination: Ker, EMA, Leu M1, B72.3 showed diffuse strong positive.
3, histopathological examination can determine the nature of the tumor.
4, blood biochemical examination to determine whether there is liver and kidney function damage and whether there is abnormal blood routine.
5, B-ultrasound
(1) Liquid occupancy: Most of them have no echo, and there are scattered echoes in the inside. The blood flow signal can be detected around.
(2) Low echo occupancy: mainly for low echo, uneven internal echo, irregular shape, internal low-resistance blood flow signal.
(3) The solidity of the capsule: Most of the echo-free echoes in the papillary and agglomerate, the boundary is still clear, and the punctate blood flow signal type can be seen in the periphery and the papillary shape.
Diagnosis
Diagnosis and diagnosis of ovarian clear cell tumor
diagnosis
According to the abdominal mass and the corresponding clinical manifestations, signs and laboratory tests can make a diagnosis.
Differential diagnosis
Ovarian clear cell tumors need to be differentiated from other epithelial tumors of the ovary such as ovarian serous tumors and mucinous tumors.
