Ishibashi Masako, Nakayama Kentaro, Shamima Yeasmin, Katagiri Atsuko, Iida Kohji, Nakayama Naomi, Miyazaki Kohji
Dept. of Obstetrics and Gynecology, Shimane University School of Medicine.
Gan To Kagaku Ryoho. 2008 May;35(5):857-61.
Endometrial stromal sarcoma (ESS) is very rare. It accounts for 0.5% of all uterine corpus malignant tumors and 10% of all malignant non-epithelial tumors. MPA is one effective hormonal treatment for ESS. We describe two cases in which patients with metastatic low-grade ESS lesions had prolonged survival with MPA therapy. Case 1 was a 50-year-old woman with a low-grade uterine endometrial stromal tumor who had been operated on at another hospital. She had been followed for three years. She had pelvis metastases with infiltration into the bladder, and pulmonary metastases. She had an incomplete response to chemotherapy. We initiated MPA therapy, which resulted in significant improvement in her metastatic lesions. Case 2 was a 58-year-old woman with stage Ic low-grade ESS who presented with abnormal uterine bleeding. Following surgery (TAH+BSO), MPA therapy was initiated and she had no recurrence. After 1 year and 7 months, she discontinued the MPA because it worsened her articular rheumatism. Her cancer recurred with pelvic and paraaortic lymph node metastasis. She was treated with chemotherapy, MPA and radiotherapy. Her metastases improved, and the patient has continued to survive on MPA therapy alone. These cases suggest that MPA might be an effective hormonal therapy for patients with low-grade ESS.
子宫内膜间质肉瘤（ESS）非常罕见。它占所有子宫体恶性肿瘤的0.5%，占所有恶性非上皮性肿瘤的10%。甲羟孕酮（MPA）是ESS的一种有效激素治疗方法。我们描述了两例转移性低级别ESS病变患者通过MPA治疗获得长期生存的病例。病例1是一名50岁女性，患有低级别子宫内膜间质肿瘤，曾在另一家医院接受手术。她已随访三年。她有盆腔转移并侵犯膀胱，还有肺转移。她对化疗反应不完全。我们开始使用MPA治疗，结果其转移性病变有显著改善。病例2是一名58岁女性，患有Ic期低级别ESS，表现为子宫异常出血。手术后（全子宫双附件切除术），开始使用MPA治疗，她未复发。1年7个月后，她因MPA加重其关节风湿症而停药。她的癌症复发并伴有盆腔和腹主动脉旁淋巴结转移。她接受了化疗、MPA和放疗。她的转移灶有所改善，患者仅通过MPA治疗持续存活。这些病例表明，MPA可能是低级别ESS患者的一种有效激素治疗方法。
