Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung, Taiwan.
Int J Gynecol Pathol. 2009 Nov;28(6):535-40. doi: 10.1097/PGP.0b013e3181aaba27.
Multiple primary malignant neoplasms are not uncommon, whereas 2 different types of primary sarcomas simultaneously presenting in 1 individual is quite unusual. We encountered a patient presenting with a uterine sarcoma and another retroperitoneal mass at the same time. These 2 tumors showed distinct pathologic and immunohistochemical features. The diagnosis of a synchronous presentation of a uterine leiomyosarcoma and a retroperitoneal sclerosing well-differentiated liposarcoma was rendered. Further study by comparative genomic hybridization showed unrelated genomic alterations of these 2 tumors. Nevertheless, other common genetic alterations such as balanced translocations, point mutations, or epigenetic modifications could still exist because of the limitation of findings by comparative genomic hybridization. In conclusion, both metastasis and multiple primary tumors should always be taken into consideration in differential diagnosis while encountering synchronous sarcomas.
多发性原发性恶性肿瘤并不罕见，而同时在 1 个个体中出现 2 种不同类型的原发性肉瘤则较为罕见。我们遇到了 1 例同时患有子宫肉瘤和腹膜后肿块的患者。这 2 种肿瘤具有明显不同的病理和免疫组织化学特征。诊断为同时发生的子宫平滑肌肉瘤和腹膜后硬化性高分化脂肪肉瘤。通过比较基因组杂交进一步研究显示，这 2 种肿瘤的基因组改变无关。然而，由于比较基因组杂交的发现存在局限性，仍然可能存在其他常见的遗传改变，如平衡易位、点突变或表观遗传修饰。总之，在遇到同时发生的肉瘤时，在鉴别诊断中应始终考虑转移和多原发性肿瘤。
