一名无性腺子宫内膜异位症病史的患者，输尿管子宫内膜异位症引发的伴鳞状分化的子宫内膜样腺癌。
Endometrioid adenocarcinoma with squamous differentiation arising from ureteral endometriosis in a patient with no history of gonadal endometriosis.
作者信息
Salerno M G, Masciullo V, Naldini A, Zannoni G F, Vellone V, Scambia G
机构信息
Division of Gynecologic Oncology, Department of Surgical Pathology, Catholic University of Sacred Heart, Rome, Italy.
出版信息
Gynecol Oncol. 2005 Dec;99(3):749-52. doi: 10.1016/j.ygyno.2005.06.056. Epub 2005 Oct 13.
BACKGROUND
Malignant transformation may occur in up to 1% of women with endometriosis and only 20% of these cases occur at extragonadal pelvic sites. Similarly, urinary tract endometriosis is rare and occurs in only 1% of all endometriotic lesions.
CASE
An endometrioid carcinoma with squamous differentiation arising from periureteral endometriosis presented as a pelvic mass encasing the right ureter. The patient had a history of total hysterectomy and bilateral salpingo-oopherectomy 8 years earlier because of bilateral serous benign cysts with right hemorrhagic corpus luteum and uterine fibroids, and has since been under unopposed estrogen replacement therapy for 5 years.
CONCLUSION
This is the second case of a malignancy arising in endometriosis presenting as an obstructive ureteral mass and the first case of a patient with this condition whose endometriosis is not consistent with a gonadal origin. An analysis of the case and related literature is presented together with the discussion of possible pathogenetic mechanisms.
背景
高达1%的子宫内膜异位症女性可能发生恶性转化，其中仅20%的病例发生在性腺外盆腔部位。同样，尿路子宫内膜异位症很罕见，仅占所有子宫内膜异位病变的1%。
病例
一例起源于输尿管周围子宫内膜异位症的伴有鳞状分化的子宫内膜样癌表现为包绕右侧输尿管的盆腔肿块。该患者8年前因双侧浆液性良性囊肿伴右侧出血性黄体及子宫肌瘤行全子宫切除术和双侧输卵管卵巢切除术，此后接受了5年的无对抗雌激素替代治疗。
结论
这是第二例子宫内膜异位症发生的恶性肿瘤表现为梗阻性输尿管肿块的病例，也是第一例子宫内膜异位症不符合性腺起源的此类患者。本文对该病例及相关文献进行了分析，并讨论了可能的发病机制。
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