Hasiakos D, Papakonstantinou K, Kondi-Paphiti A, Fotiou S
2nd Department of Obstetrics and Gynecology, University of Athens, School of Medicine, Aretaieion Hospital, Athens, Greece.
Eur J Gynaecol Oncol. 2007;28(6):483-6.
Cervical sarcomas are rare entities comprising 0.5% of all primary cervical malignancies. Endometrial stromal sarcoma (ESS) is the least common (< 10%) type of uterine sarcoma. It has traditionally been divided into two categories: low-grade stromal sarcoma (LGSS), which constitutes 50-60% of all ESS, and high-grade stromal sarcoma (HGSS). Low-grade ESS may arise in extrauterine locations, classically described as arising in foci of endometriosis. In our case, a 44-year-old woman presented with a 4-week history of abnormal vaginal secretions and occasional bleeding. Physical examination revealed a soft, hemorrhagic mass on the posterior cervix, approximately 7 x 4 x 3 cm, looking like a degenerated myoma. The patient underwent a radical hysterectomy with bilateral salpingo-oophorectomy and bilateral pelvic lymphadenectomy. Histopathological findings, including immunohistochemical study, led to the diagnosis of a LGSS of the endocervix, which was in close relation with endometriotic foci. Our case represents an extrauterine low-grade ESS arising in the endocervix, where a problem in the differential diagnosis was encountered and which was finally treated only with surgery. Adjuvant treatment of ESS is controversial. Generally, low-grade ESS is associated with good prognosis and long overall and disease-free survival.
宫颈肉瘤是罕见的实体肿瘤，占所有原发性宫颈恶性肿瘤的0.5%。子宫内膜间质肉瘤（ESS）是子宫肉瘤中最不常见的类型（<10%）。传统上它被分为两类：低度间质肉瘤（LGSS），占所有ESS的50 - 60%，以及高度间质肉瘤（HGSS）。低度ESS可能发生在子宫外部位，经典描述为发生在子宫内膜异位症病灶处。在我们的病例中，一名44岁女性出现了4周异常阴道分泌物和偶尔出血的病史。体格检查发现宫颈后部有一个柔软的、出血性肿块，大小约为7×4×3厘米，看起来像一个退变的肌瘤。患者接受了根治性子宫切除术、双侧输卵管卵巢切除术和双侧盆腔淋巴结清扫术。组织病理学检查结果，包括免疫组化研究，诊断为宫颈管低度ESS，与子宫内膜异位症病灶密切相关。我们的病例代表了发生在宫颈管的子宫外低度ESS，在此病例中遇到了鉴别诊断问题，最终仅通过手术治疗。ESS的辅助治疗存在争议。一般来说，低度ESS预后良好，总体生存期和无病生存期长。
