Imachi M, Tsukamoto N, Shigematsu T, Watanabe T, Uehira K, Amada S, Umezu T, Nakano H
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Gynecol Oncol. 1992 Oct;47(1):114-24. doi: 10.1016/0090-8258(92)90086-x.
Malignant mixed Müllerian tumors are usually found in the endometrium, vagina, cervix, and ovary. It is extremely rare for this tumor to arise in the fallopian tube, and to date only 37 tubal cases have been reported. We recently experienced 2 such cases. The clinical features, pathologic findings, diagnosis, therapy, and outcome of these 39 cases were reviewed. The clinical features and diagnosis were similar to those of primary carcinoma of the fallopian tube. Correct preoperative diagnosis was difficult. Histologically, 18 patients had homologous elements and 21 had heterologous elements in the sarcomatous components. The most common type of heterologous element was cartilage, followed by striated muscle and bone. The clinical stage (FIGO staging of ovarian carcinoma) was stage I in 15 cases, stage II in 11 cases, stage III in 8 cases, stage IV in 3 cases, and unknown in 2 cases. In all the patients except 1, the tumor was surgically removed. Postoperatively, radiotherapy was given to 9 patients, chemotherapy to 9 patients, and both to 2 patients. Sixteen patients died of the disease, after a mean period of 16.1 months. Of the 15 stage I patients, 10 survived more than 12 months. The most important prognostic factor was spread of the tumor at diagnosis.
恶性苗勒管混合瘤通常发生于子宫内膜、阴道、宫颈和卵巢。该肿瘤起源于输卵管极为罕见，迄今为止仅有37例输卵管病例报道。我们最近遇到了2例这样的病例。对这39例病例的临床特征、病理表现、诊断、治疗及转归进行了回顾。其临床特征和诊断与原发性输卵管癌相似。术前准确诊断困难。组织学上，18例患者肉瘤成分中有同源性成分，21例有异源性成分。最常见的异源性成分类型是软骨，其次是横纹肌和骨。临床分期（采用卵巢癌的FIGO分期）：Ⅰ期15例，Ⅱ期11例，Ⅲ期8例，Ⅳ期3例，2例分期不明。除1例患者外，所有患者均接受了手术切除。术后，9例患者接受了放疗，9例接受了化疗，2例同时接受了放疗和化疗。16例患者死于该疾病，平均病程为16.1个月。15例Ⅰ期患者中，10例存活超过12个月。最重要的预后因素是诊断时肿瘤的播散情况。
