McCoubrey A, Houghton O, McCallion K, McCluggage W G
Department of Surgery, Ulster Hospital, Dundonald BT16 ORH, Northern Ireland.
J Clin Pathol. 2005 Nov;58(11):1221-3. doi: 10.1136/jcp.2005.027946.
This case report describes a Mullerian serous adenocarcinoma arising within a multoloculated cyst lined by ciliated serous-type epithelium located in the sigmoid mesentery. Twenty years previously the patient underwent a hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. The ovaries contained bilateral serous cystadenofibromas, and multiple cysts lined by ciliated serous-type epithelium were present in the omentum. The resection specimen 20 years later contained a 14 cm multiloculated cyst located in the sigmoid mesentery. This was lined largely by benign ciliated serous-type epithelium but a focus of well differentiated serous adenocarcinoma projected into the lumen. Two further peritoneal cysts were present, both of which were lined by ciliated serous-type epithelium. There was a coincidental renal cell carcinoma. This is a unique case of multiple omental, peritoneal, and retroperitoneal cysts (classified as cystic endosalpingiosis), one of which developed a focus of serous adenocarcinoma. Although rarely serous adenocarcinomas, similar to those occurring within the ovary, arise in the retroperitoneum, this is the first reported occurrence in association with a pre-existing benign lesion.
本病例报告描述了一例发生于乙状结肠系膜内多房性囊肿的苗勒氏浆液性腺癌，该囊肿内衬纤毛状浆液型上皮。20年前，患者接受了子宫切除术、双侧输卵管卵巢切除术和大网膜切除术。卵巢内有双侧浆液性囊腺纤维瘤，大网膜内有多个内衬纤毛状浆液型上皮的囊肿。20年后的切除标本中，乙状结肠系膜内有一个14厘米的多房性囊肿。其大部分内衬良性纤毛状浆液型上皮，但有一个高分化浆液性腺癌灶突入腔内。还有另外两个腹膜囊肿，均内衬纤毛状浆液型上皮。同时存在一例肾细胞癌。这是一例罕见的多例网膜、腹膜和腹膜后囊肿（归类为囊性输卵管内膜异位症）病例，其中之一发生了浆液性腺癌灶。虽然浆液性腺癌很少像发生于卵巢内的那样出现在腹膜后，但这是首次报道的与先前存在的良性病变相关的病例。
