一名有皮肤恶性黑色素瘤病史的患者，异常子宫出血作为子宫内膜转移的首发症状。

Abnormal uterine bleeding as a presenting sign of metastasis to the endometrium in a patient with a history of cutaneous malignant melanoma.

作者信息

Berker Bulent, Sertcelik Ayse, Kaygusuz Gulsah, Unlu Cihat, Ortac Firat

机构信息

Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey.

出版信息

Gynecol Oncol. 2004 Apr;93(1):252-6. doi: 10.1016/j.ygyno.2004.01.012.

DOI:10.1016/j.ygyno.2004.01.012

PMID:15047246

Abstract

BACKGROUND

Metastatic melanomas to the uterus are very rare; to our knowledge, only 11 cases have been reported to date.

CASE

A 39-year-old multigravid woman with a history of cutaneous malignant melanoma presented with abnormal uterine bleeding. Histopathologic study of the endometrial biopsy showed neoplastic cells containing brown granular pigment among the endometrial glands suggesting melanoma. Immunohistochemical studies demonstrated intense reactivity of tumor cells for S-100 protein and HMB-45 confirming the diagnosis of endometrial metastatic malignant melanoma. A complete clinical workup ruled out metastatic spread to the brain, lungs, skeleton, or abdomen. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node sampling were performed. Final pathology examination revealed malignant melanoma limited to the endometrium.

CONCLUSIONS

Abnormal uterine bleeding in patients with a history of malignancy should always alert the physician to consider the diagnosis of metastatic spread to the genital tract.

摘要

背景

子宫转移性黑色素瘤非常罕见；据我们所知，迄今为止仅报道过11例。

病例

一名39岁有多次妊娠史的女性，有皮肤恶性黑色素瘤病史，出现子宫异常出血。子宫内膜活检的组织病理学研究显示，子宫内膜腺体中有含棕色颗粒状色素的肿瘤细胞，提示为黑色素瘤。免疫组织化学研究显示肿瘤细胞对S-100蛋白和HMB-45有强烈反应，证实了子宫内膜转移性恶性黑色素瘤的诊断。全面的临床检查排除了向脑、肺、骨骼或腹部的转移扩散。实施了全腹子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结取样。最终病理检查显示恶性黑色素瘤局限于子宫内膜。