Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland Medical Center, University of Maryland School of Medicine, 22 South Greene Street, Box 290, Baltimore, MD 21201, USA.
Arch Gynecol Obstet. 2009 Oct;280(4):637-41. doi: 10.1007/s00404-009-0962-y. Epub 2009 Feb 15.
Endometriosis-associated ovarian cancer arising from the surgical incision site is an unusual clinical entity.
A 37-year-old woman presented with a chief complaint of progressive swelling of the mons pubis. The patient was status post laparotomy for endometrioma/endometriosis 10 years ago. MRI showed a heterogeneous multiseptated large cystic mass within the mons pubis measuring 14 x 13.4 x 10.6 cm. Initial cytoreductive surgery revealed no evidence of tumor in the peritoneal cavity. The surgery was suboptimal due to severe adhesions to the symphysis pubis. The secondary cytoreductive surgery performed after six cycles of taxotere and carboplatin was optimal. Macroscopically, the tumor was a dusky pink-purple and contained a dense white-gray to light yellow gelatinous area. The tumor was a malignant cystic and glandular neoplasm. Immunohistochemical stains included CK7(+), CK5/6(-), EMA(+), Ber-Ep4(+), Calretinin(-), ER(-), and PR(-).
Primary peritoneal clear cell adenocarcinoma arising from an abdominal scar associated with prior endometrioma/endometriosis surgery was first reported.
起源于手术切口的子宫内膜异位症相关卵巢癌是一种罕见的临床实体。
一名 37 岁女性因耻骨联合上方进行性肿胀为主诉就诊。该患者 10 年前因卵巢子宫内膜异位囊肿/子宫内膜异位症行剖腹手术。MRI 显示耻骨联合上方有一个不均匀的多分隔大囊性肿块，大小为 14 x 13.4 x 10.6 cm。初步减瘤手术显示腹腔内无肿瘤证据。由于耻骨联合严重粘连，手术效果不佳。在紫杉醇和卡铂治疗 6 个周期后进行了二次减瘤手术，效果最佳。大体上，肿瘤呈暗粉紫色，含有致密的白灰色至浅黄色胶状区域。肿瘤为恶性囊性和腺性肿瘤。免疫组化染色包括 CK7(+)、CK5/6(-)、EMA(+)、Ber-Ep4(+)、Calretinin(-)、ER(-)和 PR(-)。
首次报道了与先前卵巢子宫内膜异位囊肿/子宫内膜异位症手术相关的腹壁疤痕处发生的原发性腹膜透明细胞腺癌。
