Chang H C, Hsueh S, Soong Y K
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1991 Dec;14(4):259-63.
Malignant mixed müllerian tumor of the fallopian tube is extremely rare, with less than 50 cases recorded in the English literature. Another case is reported and discussed. This 66-year-old female patient complained of profuse watery vaginal discharge for one month. Vaginal cytology was positive for malignancy while the endometrial curettage and cervical biopsy were both negative. Gynecologic sonography revealed a left adnexal mass of 6 cm in diameter. She underwent exploratory laparotomy after complete oncologic survey. The main tumor was confined to one tube but the peritoneal washing cytology was positive for adenocarcinoma cells. She tolerated the maximal debulking surgery very well but refused to receive adjuvant chemotherapy. Pathology proved that the tumor was composed of poorly differentiated adenocarcinoma and sarcoma. There were focal areas of rhabdomyoblastic differentiation with cross striation in immunoperoxidase stain. Carcinomatosis peritonii occurred 12 months after primary surgery and she expired one month later.
输卵管恶性苗勒管混合瘤极为罕见，英文文献中记录的病例不到50例。本文报告并讨论了另一例病例。该66岁女性患者主诉水样白带增多1个月。阴道细胞学检查提示恶性，但子宫内膜刮除术和宫颈活检均为阴性。妇科超声检查发现左侧附件有一个直径6 cm的肿块。在完成全面的肿瘤学评估后，她接受了剖腹探查术。主要肿瘤局限于一侧输卵管，但腹腔冲洗液细胞学检查发现腺癌细胞阳性。她对最大程度的肿瘤减灭术耐受性良好，但拒绝接受辅助化疗。病理证实肿瘤由低分化腺癌和肉瘤组成。免疫过氧化物酶染色显示有局灶性横纹肌母细胞分化，可见横纹。初次手术后12个月发生腹膜癌转移，1个月后患者死亡。
