Chen Chi Chiung Grace, Straughn J Michael, Kilgore Larry C
Division of Gynecologic Oncology, University of Alabama, Birmingham, Alabama, USA.
Obstet Gynecol. 2004 Nov;104(5 Pt 2):1170-2. doi: 10.1097/01.AOG.0000123268.57857.0d.
Although most patients with a surgical stage I endometrial cancer have an excellent prognosis, some patients will experience a recurrence. Endometrial cancer typically recurs at the vaginal cuff or in the pelvis; however, it can recur distantly in the abdomen or lung. Although recurrences have been reported at laparoscopic trochar sites, it is unusual to have a recurrence in the abdominal incision after laparotomy.
A 51-year-old woman was diagnosed with stage Ib grade 2 adenocarcinoma of the endometrium and stage IV endometriosis. Six months after surgery, she presented with a mass in the lateral aspect of her Maylard incision. Computed tomography scans of the chest, abdomen, and pelvis showed no evidence of recurrent disease. The mass was resected and confirmed to be an adenocarcinoma similar to the endometrial primary.
This case is interesting because of the rapid recurrence of the endometrial primary at an unusual site-the abdominal incision. It illustrates the need to carefully evaluate all suspicious masses, even as early as 6 months after diagnosis and surgical staging.
虽然大多数手术分期为I期的子宫内膜癌患者预后良好，但仍有一些患者会出现复发。子宫内膜癌通常在阴道残端或盆腔复发；然而，它也可能在腹部或肺部远处复发。虽然已有腹腔镜穿刺部位复发的报道，但开腹术后腹部切口处复发并不常见。
一名51岁女性被诊断为子宫内膜Ib期2级腺癌和IV期子宫内膜异位症。术后6个月，她在麦氏切口外侧出现一个肿块。胸部、腹部和盆腔的计算机断层扫描未显示复发疾病的迹象。该肿块被切除，病理证实为与子宫内膜原发癌相似的腺癌。
该病例很有意思，因为子宫内膜原发癌在一个不寻常的部位——腹部切口迅速复发。它表明即使在诊断和手术分期后仅6个月，也需要仔细评估所有可疑肿块。
