Bosincu L, Massarelli G, Cossu Rocca P, Isaac M A, Nogales F F
Departments of Pathology, University of Sassari, Sardinia, Italy.
Dis Colon Rectum. 2001 Jun;44(6):890-2. doi: 10.1007/BF02234715.
Endometriosis of the rectovaginal septum can harbor different types of secondary tumors that may involve the rectal wall and protrude into its lumen, thus making diagnosis difficult. Extrauterine low-grade endometrial stromal sarcoma may rarely arise in endometriosis. The purpose of this article was to present the third case of this association.
This was a clinicopathologic study.
A 42-year-old female presented with abdominal pain and fever. Laparotomy revealed a large pelvic mass involving the rectovaginal septum and the colonic wall and which protruded into the lumen forming endoluminal polypoid masses. Concomitant peritoneal nodules and a metastatic paracolic lymph node were also found. Histopathologically, primary endometriotic foci were found in close relationship with an endometrial stromal sarcoma which invaded the rectal wall. The female genital tract had no endometriotic lesions. The patient was treated by surgery and subsequent chemotherapy and was alive and well 20 months later.
Endometriosis and its possible malignant changes should be taken into account in the differential endoscopic diagnosis of rectal masses in females.
直肠阴道隔子宫内膜异位症可伴有不同类型的继发性肿瘤，这些肿瘤可能累及直肠壁并突入肠腔，从而使诊断困难。子宫外低级别子宫内膜间质肉瘤很少在子宫内膜异位症中发生。本文的目的是报告这种关联的第三例病例。
这是一项临床病理研究。
一名42岁女性出现腹痛和发热。剖腹探查发现一个巨大的盆腔肿物，累及直肠阴道隔和结肠壁，并突入肠腔形成腔内息肉样肿物。同时还发现了腹膜结节和一个转移性结肠旁淋巴结。组织病理学检查发现，原发性子宫内膜异位病灶与侵袭直肠壁的子宫内膜间质肉瘤关系密切。女性生殖道无子宫内膜异位病变。该患者接受了手术及后续化疗，20个月后仍存活且状况良好。
在女性直肠肿物的内镜鉴别诊断中，应考虑子宫内膜异位症及其可能的恶性变化。
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