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外阴纤维腺瘤——同时伴有乳腺纤维腺瘤和子宫肌瘤。

Fibroadenoma of the vulva--simultaneous with breast fibroadenomas and uterine myoma.

机构信息

Department of Obstetrics and Gynecology, Maternal and Newborn Hospital, Cordoba, Argentina.

出版信息

J Low Genit Tract Dis. 2011 Jan;15(1):75-9. doi: 10.1097/LGT.0b013e3181de72e5.

Abstract

PURPOSE

To present a rare case of multiple fibroadenomas in breast and vulva and myomas in the uterus. In addition, to show the usefulness of receptor detection as a basis for the indication of antiestrogens.

CASE

A 30-year-old patient presenting with a history of mammary fibroadenomas since the age of 16 years and uterine myomas since the age of 25 years. From age 26 to 29 years, she was operated on 3 times for fibroadenomas of the vulva. On the third time, she presented with 8 vulvar fibroadenomas. On this last occasion, a low expression of estrogen receptors was identified, together with a high expression of progesterone receptors (ER/PR pharmDx; Dako). Tamoxifen was indicated at 10 mg/d during the luteal phase of the menstrual cycle for 12 months. After 18 months from initiation of the treatment, the patient was found free of tumors in the vulva, with mammary tumor regression and a nonhomogeneous diffuse uterine myometrium.

CONCLUSIONS

The presence of solid benign-type tumors in the vulva associated with mammary fibroadenomas and uterine myomas leads one to suspect the fibroadenomas. The histopathological diagnosis and the identification of the hormonal receptors are important for control purposes and therapeutic indications.

摘要

目的

报告 1 例乳房和外阴多发性纤维腺瘤和子宫平滑肌瘤病例,并展示受体检测作为抗雌激素治疗指征的重要性。

病例

患者 30 岁,16 岁时出现乳腺纤维腺瘤病史,25 岁时出现子宫平滑肌瘤病史。26 岁至 29 岁间,她因外阴纤维腺瘤已接受了 3 次手术。第 3 次手术时,发现有 8 个外阴纤维腺瘤。此次最后一次检查中,雌激素受体(ER)表达低,孕激素受体(PR)表达高(ER/PR pharmDx;Dako)。黄体期给予他莫昔芬 10mg/d,连续 12 个月。治疗开始后 18 个月,患者外阴肿瘤消失,乳腺肿瘤消退,子宫肌层不均匀弥漫性。

结论

外阴实性良性肿瘤与乳腺纤维腺瘤和子宫平滑肌瘤并存,提示可能存在纤维腺瘤。组织病理学诊断和激素受体的鉴定对于控制和治疗指征很重要。

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