Fambrini Massimiliano, Andersson Karin Louise, Buccoliero Anna Maria, Pieralli Annalisa, Livi Lorenzo, Marchionni Mauro
Department of Gynecology, Perinatology and Human Reproduction, Viale Morgagni, Florence, Italy.
J Obstet Gynaecol Res. 2008 Aug;34(4 Pt 2):731-4. doi: 10.1111/j.1447-0756.2008.00917.x.
We present the case of a 52-year-old woman with a history of excised cutaneous malignant melanoma complaining of abnormal uterine bleeding 11 years after initial diagnosis. Hysteroscopic examination showed an endometrial lesion with polypoid shape and endometrial biopsy was suggestive for melanoma. After a complete clinical work-up ruling out other metastatic sites, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Final histopathological and immunohistochemical analysis confirmed the diagnosis of endometrial melanoma with initial myometrial invasion. After a 6-month follow-up period, the patient was disease free. Even after many years of negative follow up, gynecologists should be aware of the possibility that abnormal uterine bleeding could represent the clinical expression of metastatic melanoma in order to offer a prompt diagnosis and a personalized strategy of treatment.
我们报告一例52岁女性病例，该患者有皮肤恶性黑色素瘤切除病史，在初次诊断11年后出现异常子宫出血。宫腔镜检查显示子宫内膜病变呈息肉样，子宫内膜活检提示为黑色素瘤。在完成全面的临床检查排除其他转移部位后，患者接受了全腹子宫切除术、双侧输卵管卵巢切除术及盆腔淋巴结清扫术。最终的组织病理学和免疫组化分析证实为子宫内膜黑色素瘤伴肌层浸润。经过6个月的随访期，患者无疾病复发。即使经过多年的阴性随访，妇科医生仍应意识到异常子宫出血可能是转移性黑色素瘤的临床表现，以便及时诊断并提供个性化的治疗策略。
