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巨大子宫平滑肌瘤致双侧肾积水并存息肉样子宫内膜癌:病例报告

Giant uterine leiomyomas causing bilateral hydronephrosis coexisting with endometrial cancer in polyp: a case study.

作者信息

Semczuk A, Skorupski P, Olcha P, Skomra D, Rechberger T, Gogacz M

机构信息

2nd Department of Gynecology, Lublin Medical University, Lublin, Poland.

出版信息

Eur J Gynaecol Oncol. 2009;30(3):344-6.

Abstract

Multiple uterine leiomyomas are present in a large population of women and may cause several uncommon clinical symptoms, including disseminated vein thrombosis and hydronephrosis. We report a case of giant uterine leiomyomas causing bilateral hydronephrosis coexisting with endometrial cancer (EC) deriving from a uterine polyp. A 50-year-old woman was admitted due to bilateral hydronephrosis caused by monstrous abdominal tumor to the IInd Department of Gynecology, Lublin Medical University, Lublin, Poland. A bilateral double-J catheter was inserted. Pelvic examination revealed a huge, rough tumor, originating from the uterus. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and a giant uterus weighing 15.2 kg and measuring 35 x 29 x 18 cm was removed. Histopathological examination revealed multiple uterine leiomyomas with calcification and partial necrosis, and well-differentiated (G1), endometrioid-type EC (Stage IA) concomitant with atypical endometrial hyperplasia, deriving from a uterine polyp. The postoperative recovery was without complications, and the patient was discharged on postoperative day 10. In conclusion, giant uterine leiomyoma may incidentally compress the urinary tract organs, causing hydronephrosis.

摘要

众多女性人群中存在多发性子宫平滑肌瘤,其可能引发多种罕见临床症状,包括弥散性静脉血栓形成和肾积水。我们报告一例巨大子宫平滑肌瘤导致双侧肾积水并与源自子宫息肉的子宫内膜癌(EC)共存的病例。一名50岁女性因巨大腹部肿瘤导致双侧肾积水入住波兰卢布林医科大学卢布林第二妇科。插入双侧双J导管。盆腔检查发现一个巨大、表面粗糙的肿瘤,起源于子宫。实施了全腹子宫切除术及双侧输卵管卵巢切除术,切除了一个重达15.2千克、尺寸为35×29×18厘米的巨大子宫。组织病理学检查显示为多发性子宫平滑肌瘤伴钙化和部分坏死,以及高分化(G1)、子宫内膜样型EC(IA期),同时伴有源自子宫息肉的非典型子宫内膜增生。术后恢复无并发症,患者于术后第10天出院。总之,巨大子宫平滑肌瘤可能偶然压迫泌尿系统器官,导致肾积水。

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