与克罗恩病相关的直肠阴道瘘中发生的黏液腺癌。
Mucinous adenocarcinoma arising in rectovaginal fistulas associated with Crohn's disease.
作者信息
Moore-Maxwell Crystal A, Robboy Stanley J
机构信息
Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
出版信息
Gynecol Oncol. 2004 Apr;93(1):266-8. doi: 10.1016/j.ygyno.2003.11.056.
BACKGROUND
Crohn's disease is a chronic inflammatory disorder characterized by focal, transmural inflammation of the intestine. Gynecologic involvement, including rectovaginal fistula formation, is frequent. Case #1. A 53-year-old female with a 30-year history of Crohn's disease and numerous perirectal fistulas developed a foul smelling, purulent drainage from her rectum and a mucopurulent, bloody discharge from her vagina. A lower vaginal lesion biopsy demonstrated a low-grade mucinous adenocarcinoma. Case #2. A 42-year-old female with a 15-year history of Crohn's disease developed drainage from her vagina. Physical examination revealed an enlarging mass involving the posterior wall of the vaginal vault that connected to the anus by a fistula tract. A biopsy revealed mucinous adenocarcinoma.
CONCLUSIONS
Malignant transformation of persistent rectovaginal fistulas is a potential complication of Crohn's disease.
背景
克罗恩病是一种慢性炎症性疾病，其特征为肠道的局灶性透壁性炎症。妇科受累情况很常见，包括直肠阴道瘘的形成。病例1：一名53岁女性，有30年克罗恩病病史且有多处直肠周围瘘，出现直肠有恶臭脓性分泌物及阴道有黏液脓性血性分泌物。阴道下段病变活检显示为低级别黏液腺癌。病例2：一名42岁女性，有15年克罗恩病病史，出现阴道分泌物。体格检查发现阴道穹窿后壁有一肿物且不断增大，通过瘘管与肛门相连。活检显示为黏液腺癌。
结论
持续性直肠阴道瘘的恶性转化是克罗恩病的一种潜在并发症。
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