Al-Badr A, Faught W
Division Gynecologic Oncology, Department of Ob/Gyn, University of Ottawa, Ottawa, Ontario, Canada.
Obstet Gynecol. 2001 May;97(5 Pt 2):836-7.
Uterine sarcomas are rare malignancies that resemble benign uterine leiomyomata. Uterine artery embolization is offered increasingly for treatment of uterine leiomyomata, which might lead to embolization of undiagnosed uterine sarcoma.
A 52-year-old woman, gravida 7, para 6, with perimenopausal menometrorrhagia was diagnosed with uterine leiomyomata after physical examination and transvaginal ultrasound. An endometrial biopsy was negative for malignancy. After medical treatment was unsuccessful, she had uterine artery embolization. She then passed a piece of tissue from her vagina, the pathology report of which was necrotic high-grade sarcoma. During surgery we confirmed that the tumor was confined to the uterus.
Uterine sarcoma cannot be diagnosed except by pathologic examination of a resected specimen. Women considering uterine artery embolization for treatment of apparent leiomyomata should be counseled on the risk of decreased survival by delaying diagnosis and treatment of uterine sarcoma.
子宫肉瘤是一种罕见的恶性肿瘤，与良性子宫平滑肌瘤相似。子宫动脉栓塞术越来越多地用于治疗子宫平滑肌瘤，这可能导致未被诊断出的子宫肉瘤发生栓塞。
一名52岁女性，孕7产6，有围绝经期月经过多症状，经体格检查和经阴道超声检查后被诊断为子宫平滑肌瘤。子宫内膜活检未发现恶性病变。药物治疗无效后，她接受了子宫动脉栓塞术。随后她从阴道排出一块组织，病理报告显示为坏死性高级别肉瘤。手术中我们证实肿瘤局限于子宫。
子宫肉瘤只有通过切除标本的病理检查才能确诊。对于考虑采用子宫动脉栓塞术治疗明显平滑肌瘤的女性，应告知她们因延迟子宫肉瘤的诊断和治疗而降低生存率的风险。
