Department of Pathology and Laboratory Medicine, Pathology Section, University of Parma, Viale A. Gramsci 14, Parma, Italy.
Int J Gynecol Pathol. 2010 Sep;29(5):459-67. doi: 10.1097/PGP.0b013e3181dfcfdc.
Uterine neoplasms showing an exclusive sex cord-like differentiation or focal low-grade sarcoma differentiation, designated as uterine tumors resembling ovarian sex cord tumors (UTROSCTs), are rare, with only 48 cases described earlier in international literature. Generally, this entity is characterized by benign behavior. In this study, we report the clinical and pathologic features of 2 peculiar new cases of UTROSCTs. In these examples, the pathologic diagnosis of UTROSCT was made incidentally after the clinical diagnosis of a leiomyoma and endometrial polyp. On examination of small biopsies, the diagnosis was facilitated by specific immunohistochemical analysis using markers for the sex cord component. In 1 of these cases, the patient, because of her young age and her desire to preserve her fertility, was only treated by minimally invasive hysteroscopic surgery. In the other case, the neoplasm seemed to be the consequence of tamoxifen treatment for breast carcinoma. After diagnosis, in this second case, the woman underwent hysterectomy that showed a residue of the tumor and cervical metastasis from the earlier breast carcinoma. The differential diagnosis of UTROSCT and the role of immunohistochemistry in confirming a diagnosis are discussed.
表现为独特性索样分化或局灶性低度恶性肉瘤分化的子宫肿瘤，被指定为类似于卵巢性索肿瘤的子宫肿瘤（UTROSCT），十分罕见，国际文献中此前仅描述过 48 例。一般来说，这种肿瘤的行为呈良性。本研究报告了 2 例罕见的新的 UTROSCT 病例的临床和病理特征。在这些病例中，UTROSCT 的病理诊断是在临床诊断为子宫肌瘤和子宫内膜息肉后偶然做出的。通过使用性索成分标志物进行特定的免疫组织化学分析，对小活检进行检查，有助于做出诊断。在其中 1 例中，由于患者年龄较小且希望保留生育能力，仅接受了微创的宫腔镜手术治疗。在另 1 例中，肿瘤似乎是因乳腺癌而接受他莫昔芬治疗的结果。诊断后，在第二例中，患者接受了子宫切除术，结果显示肿瘤残留和先前乳腺癌的宫颈转移。讨论了 UTROSCT 的鉴别诊断和免疫组织化学在确认诊断中的作用。
