Carinelli Silvestro, Motta Francesca, Frontino Giada, Restelli Elisa, Fedele Luigi
Department of Anatomopathology, Fondazione Instituto di Ricovero e Cura a Carattere Scientifico di Natura Publica, Policlinico-Mangiagalli-Regina Elena, University of Milan, Milan, Italy.
Fertil Steril. 2009 May;91(5):1956.e9-11. doi: 10.1016/j.fertnstert.2009.01.076. Epub 2009 Feb 28.
To describe two rare cases of multiple extrauterine adenomyomas, their clinical management, and their response to surgical and hormone therapy with GnRH agonist.
Case report and review of the English-language scientific literature.
Cases presented in a tertiary health care academic institution.
PATIENT(S): Two patients without urogenital malformations diagnosed with extrauterine adenomyoma, which is a benign tumor composed of smooth muscle and endometrium, typically originating within the uterus.
INTERVENTION(S): Surgical radical excision of adenomyomas followed by a long-term hormone therapy with GnRH agonist.
MAIN OUTCOME MEASURE(S): Anatomical and clinical outcomes.
RESULT(S): Surgical treatment followed by long-term GnRH agonist therapy appeared effective in keeping the disease stable. After a long-term follow-up of 10 and 4 years, the two patients are still asymptomatic and stable.
CONCLUSION(S): Only 19 other cases of extrauterine adenomyomas are reported in the English-language scientific literature, and no cases of multiple masses are described until now. It is probable that these extrauterine adenomyomas arose from a metaplastic transformation of the subcelomic mesenchyme. Long-term GnRH agonist therapy after surgery appeared effective in keeping the disease stable.
描述两例罕见的多发性子宫外子宫腺肌瘤病例、其临床处理方法以及对手术和GnRH激动剂激素治疗的反应。
病例报告及对英文科学文献的综述。
在一家三级医疗学术机构中呈现的病例。
两名无泌尿生殖系统畸形的患者，被诊断患有子宫外子宫腺肌瘤，这是一种由平滑肌和子宫内膜组成的良性肿瘤，通常起源于子宫内。
对子宫腺肌瘤进行手术根治性切除，随后采用GnRH激动剂进行长期激素治疗。
解剖学和临床结果。
手术治疗后长期使用GnRH激动剂治疗似乎能有效维持病情稳定。经过10年和4年的长期随访，两名患者仍无症状且病情稳定。
英文科学文献中仅报道了另外19例子宫外子宫腺肌瘤病例，目前尚无多发肿块的病例描述。这些子宫外子宫腺肌瘤可能起源于间皮间充质的化生转化。手术后长期使用GnRH激动剂治疗似乎能有效维持病情稳定。
